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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000869

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Gerald HenryDoucette Sex Male

Date of Birth May 5, 1922 Place of Birth YarmouthCounty of Yarmouth

Name of Father   MAIDEN NAME of Mother Mary Rose doucette

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Present address of Father

Occupation of Father at Birth of child Place of birth of Father

Race Name and present address of Physician in attendance at birth

Signature of Applicant Gerald Henry Doucette Address of Applicant 2018 Martin Grove Road, Unit 65, Rexdale, Ontario, M9V 4A3 Date 16 November 1981

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Gerald HenryDoucette

Born at Yarmouth in the County of Yarmouth

That Gerald HenryDoucette Whose Birth is sought to be registered was

born at Yarmouth Yarmouth County on May 5, 1922

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

I attach copy of certificate of birth and baptism certificate from St. Ambrose Cathedral, Yarmouth. I lived in Yarmouth from birth to 1953, except for when I was in the Canadian Army from 1939 to 1946 and I attach a copy of my discharge certificate - Canadian Army.

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