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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91600617

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Clarence JosephBoudreau Sex Male

Date of Birth March 2, 1923 Place of Birth SydneyCounty of Cape Breton

Name of Father Jeffrey Boudreau MAIDEN NAME of Mother Matilda Madigan

Residence of Father when child was born Sydney, Cape Breton Co., NS Present address of Father 5204 Wabash, Detroit, Michigan

Occupation of Father at Birth of child Electrician Place of birth of Father Arichat, Richmond Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Matilda Boudreau Address of Applicant 5204 Wabash, Detroit, Michigan Date 27 April 1942

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Clarence JosephBoudreau

Born at Sydney in the County of Cape Breton

That Clarence JosephBoudreau Whose Birth is sought to be registered was

born at Sydney Cape Breton County on March 2, 1923

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

Being the mother of said Clarence Joseph Boudreau

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