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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000609

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Leo DeCosteMosher Sex Male

Date of Birth August 20, 1923 Place of Birth SydneyCounty of Cape Breton

Name of Father Irving Palmer Mosher MAIDEN NAME of Mother Jennie Burdette Mosher

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

Residence of Father when child was born Sydney Cape Breton Co. Ns Present address of Father Halifax, NS

Occupation of Father at Birth of child Steel Worker Place of birth of Father Martin's Point, Lunenburg Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Leo Decoste Mosher Address of Applicant 23 Central Avenue, Fairview, Halifax Co., NS Date July 1977

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Leo DeCosteMosher

Born at Sydney in the County of Cape Breton

That Leo DeCosteMosher Whose Birth is sought to be registered was

born at Sydney Cape Breton County on August 20, 1923

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

Court finding

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