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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100034

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Regina AlbertaDorant Sex Female

Date of Birth August 15, 1922 Place of Birth New WaterfordCounty of Cape Breton

Name of Father Ormand Dorant MAIDEN NAME of Mother Irma (Emma) DesCamps

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

Residence of Father when child was born New Waterford, Cape Breton Present address of Father Deceased

Occupation of Father at Birth of child Miner Place of birth of Father Barbados, British West Indies

Race Name and present address of Physician in attendance at birth

Signature of Applicant Regina Alberta (Dorant) Chambers Address of Applicant 3080 - 6th Street, Chomedey, Laval, Quebec, H7V 1M6 Date 18 December 1985

Relationship of Applicant to child Same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Regina AlbertaDorant

Born at New Waterford in the County of Cape Breton

That Regina AlbertaDorant Whose Birth is sought to be registered was

born at New Waterford Cape Breton County on August 15, 1922

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

The attached baptism certificate as well as records kept by my parents - family bible, school records, etc.

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