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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100042

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary KathleenDeCoste Sex Female

Date of Birth February 2, 1922 Place of Birth Havre BoucherCounty of Antigonish

Name of Father william DeCoste MAIDEN NAME of Mother Florence Pettipas

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

Residence of Father when child was born Havre Boucher, Antigonish Present address of Father Deceased

Occupation of Father at Birth of child Fisherman Place of birth of Father Havre Boucher, Antigonish

Race Name and present address of Physician in attendance at birth

Signature of Applicant Joan Berkvens Address of Applicant 54 Moxam Court, Waverley, Halifax Date 30 April 1986

Relationship of Applicant to child Daughter

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary KathleenDeCoste

Born at Havre Boucher in the County of Antigonish

That Mary KathleenDeCoste Whose Birth is sought to be registered was

born at Havre Boucher Antigonish County on February 2, 1922

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

Baptismal

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