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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100152

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Marie PriscilleGaudet Sex

Date of Birth April 2, 1922 Place of Birth ConcessionCounty of Digby

Name of Father Denis Joseph Gaudet MAIDEN NAME of Mother Emma Marie Boudreau

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

Residence of Father when child was born Concession, Digby Present address of Father

Occupation of Father at Birth of child Place of birth of Father Concession, Digby

Race Name and present address of Physician in attendance at birth

Signature of Applicant Priscilla Comeau Address of Applicant 189 Canterbury Street, Ingersoll, Ontario, N5C 1E2 Date 12 September 2006

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Marie PriscilleGaudet

Born at Concession in the County of Digby

That Marie PriscilleGaudet Whose Birth is sought to be registered was

born at Concession Digby County on April 2, 1922

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

Birth and baptismal certificate, marriage certificate, social insurance number 107 599 177

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