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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000660

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth November 6, 1923 Place of Birth Sydney MinesCounty of Cape Breton

Name of Father William Blase Butts MAIDEN NAME of Mother Esther Ann Hurst

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

Residence of Father when child was born Sydney Mines Cape Breton Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Miner Place of birth of Father Sydney Mines, Cape Breton Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Jenney M. Smith Address of Applicant 1918 Gilbert Avenue, Medicine Hat, Alberta Date 20 July 1978

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Sydney Mines in the County of Cape Breton

That Jeanne MaryButts Whose Birth is sought to be registered was

born at Sydney Mines Cape Breton County on November 6, 1923

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

Certificate of Baptism from the Parish of the Immaculate Conception, Sydney Mines, signed by the Parish Priest and bearing the Parish seal.

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