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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000956

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Alice MayFougere Sex Female

Date of Birth May 11, 1922 Place of Birth Victoria MinesCounty of Cape Breton

Name of Father Simon Fougere MAIDEN NAME of Mother Victoria Gracie

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

Residence of Father when child was born Victoria Mines, Cape Breton Present address of Father Deceased

Occupation of Father at Birth of child Mine Worker Place of birth of Father Inverness County

Race Name and present address of Physician in attendance at birth

Signature of Applicant Alice Gale Address of Applicant RR #1, South Bar, Sydney, Cape Breton Date 17 October 1983

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Alice MayFougere

Born at Victoria Mines in the County of Cape Breton

That Alice MayFougere Whose Birth is sought to be registered was

born at Victoria Mines Cape Breton County on May 11, 1922

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

This is my own birth Baptismal

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