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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000940

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Charles Victor EmmanuelArsenault Sex Male

Date of Birth November 22, 1922 Place of Birth AmherstCounty of Cumberland

Name of Father clarence Arsenault MAIDEN NAME of Mother Martha Purdy

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

Residence of Father when child was born Amherst, Cumberland Present address of Father Deceased

Occupation of Father at Birth of child Labourer Place of birth of Father Amherst, Cumberland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Victor Arsenault Address of Applicant 35 Jannet Street, Brighton, Digby Date 27 June 1983

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Charles Victor EmmanuelArsenault

Born at Amherst in the County of Cumberland

That Charles Victor EmmanuelArsenault Whose Birth is sought to be registered was

born at Amherst Cumberland County on November 22, 1922

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

Baptism

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