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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000473

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Evangeline RitaChiasson Sex Female

Date of Birth October 24, 1923 Place of Birth InvernessCounty of Inverness

Name of Father Patrick Chiasson MAIDEN NAME of Mother Mary C. Gallant

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

Residence of Father when child was born Present address of Father Deceased

Occupation of Father at Birth of child Fisherman Place of birth of Father

Race Name and present address of Physician in attendance at birth

Signature of Applicant Betty Jean Kirby Address of Applicant 10 Strath Lane, Dartmouth, NS Date 2 August 1973

Relationship of Applicant to child Daughter

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Evangeline RitaChiasson

Born at Inverness in the County of Inverness

That Evangeline RitaChiasson Whose Birth is sought to be registered was

born at Inverness Inverness County on October 24, 1923

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

Baptismal certificate

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