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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000768

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Harold HarryDoucette Sex Male

Date of Birth October 24, 1922 Place of Birth HalifaxCounty of Halifax

Name of Father John Doucette MAIDEN NAME of Mother Mary Rochel

Were the Parents married at the time of the Birth? Yes

Residence of Father when child was born Halifax Present address of Father Deceased

Occupation of Father at Birth of child Seaman Place of birth of Father Petit de Grat, Richmond

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Jeanette Doucette Address of Applicant 6173 Allen Street, Halifax Date 1 August 1979

Relationship of Applicant to child wife

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Harold HarryDoucette

Born at Halifax in the County of Halifax

That Harold HarryDoucette Whose Birth is sought to be registered was

born at Halifax Halifax County on October 24, 1922

My knowledge of the fact and date of such Birth is based on the following Circumstances:

Baptismal certificate

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