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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91600722

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of John AndrewCouture Sex Male

Date of Birth April 16, 1923 Place of Birth SydneyCounty of Cape Breton

Name of Father Clifford Couture MAIDEN NAME of Mother Margaret Morley

Residence of Father when child was born Davenport Road, Sydney, Cape Breton Co., NS Present address of Father 23 Newbury Street, Sydney, Cape Breton Co., NS

Occupation of Father at Birth of child Labourer Place of birth of Father Quebec

Race Name and present address of Physician in attendance at birth

Signature of Applicant Margaret Couture Address of Applicant 23 Newbury Street, Sydney, Cape Breton Co., NS Date 30 May 1942

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of John AndrewCouture

Born at Sydney in the County of Cape Breton

That John AndrewCouture Whose Birth is sought to be registered was

born at Sydney Cape Breton County on April 16, 1923

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

I am his mother

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