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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000483

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary Audrey PaulinePatriquin Sex Female

Date of Birth May 27, 1923 Place of Birth AmherstCounty of Cumberland

Name of Father Perley Alfred Patriquin MAIDEN NAME of Mother Anna May Cormier

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

Residence of Father when child was born Amherst Cumberland Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Machinist Place of birth of Father Wallace River, Cumberland Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Audrey Rand Address of Applicant 6056 South Street, Apt. 5, Halifax, NS Date 17 January 1974

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary Audrey PaulinePatriquin

Born at Amherst in the County of Cumberland

That Mary Audrey PaulinePatriquin Whose Birth is sought to be registered was

born at Amherst Cumberland County on May 27, 1923

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

Baptism.

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