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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000695

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Alma GertrudeBoutilier Sex Female

Date of Birth September 3, 1923 Place of Birth MushaboomCounty of Halifax

Name of Father Alfred Rheuben Boutilier MAIDEN NAME of Mother Nancy Boutilier

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

Residence of Father when child was born Mushaboom Halifax Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Place of birth of Father Mushaboom, Halifax Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Address of Applicant 16 Hartlen Avenue, Halifax, NS Date 30 January 1979

Relationship of Applicant to child Daughter

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Alma GertrudeBoutilier

Born at Mushaboom in the County of Halifax

That Alma GertrudeBoutilier Whose Birth is sought to be registered was

born at Mushaboom Halifax County on September 3, 1923

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

Baptismal

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