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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000639

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Jeanne FrancoiseAmirault Sex Female

Date of Birth November 15, 1923 Place of Birth Lower East PubnicoCounty of Yarmouth

Name of Father Albert Joseph Amirault MAIDEN NAME of Mother Rose A. Jacquard

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

Residence of Father when child was born Lower East Pubnico Yarmouth Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Workman with Canadian National Railway Place of birth of Father Lower East Pubnico, Yarmouth Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Jeanne Francoise Amirault Address of Applicant Lower East Pubnico, Yarmouth Co., NS Date 18 April 1978

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Jeanne FrancoiseAmirault

Born at Lower East Pubnico in the County of Yarmouth

That Jeanne FrancoiseAmirault Whose Birth is sought to be registered was

born at Lower East Pubnico Yarmouth County on November 15, 1923

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

As noted above I was present in the village and actually live next door to Jeanne Francoise Amirault and have known Jeanne Francoise Amirault all her lifetime.

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