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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91700220

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Lorraine CorinnePoirier Sex Female

Date of Birth October 29, 1921 Place of Birth PoiriervilleCounty of Richmond

Name of Father Alexander Paacien Poirier MAIDEN NAME of Mother Alexandrine Poirier

Residence of Father when child was born Poirierville, Richmond Co., NS Present address of Father Poirierville, Richmond Co., NS

Occupation of Father at Birth of child Mariner Place of birth of Father Poirierville, Richmond Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Alexandrine Poirier Address of Applicant Poirierville, Richmond Co., NS Date 10 October 1942

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Lorraine CorinnePoirier

Born at Poirierville in the County of Richmond

That Lorraine CorinnePoirier Whose Birth is sought to be registered was

born at Poirierville Richmond County on October 29, 1921

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

I am the mother of the above Lorraine Corinne Poirier whose birth is sought to be registered and I know the circumstances of her birth fully.

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