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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000829

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of LaurenaLeBlanc Sex Male

Date of Birth February 10, 1923 Place of Birth PoiriervilleCounty of Richmond

Name of Father Joseph Leblanc MAIDEN NAME of Mother Margaret Sampson

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

Residence of Father when child was born Poirierville Richmond Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Sailor Place of birth of Father Arichat

Race Name and present address of Physician in attendance at birth

Signature of Applicant Laurence Leblanc Address of Applicant 5489 Tobin Street, Halifax, NS Date 11 June 1982

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of LaurenaLeBlanc

Born at Poirierville in the County of Richmond

That LaurenaLeBlanc Whose Birth is sought to be registered was

born at Poirierville Richmond County on February 10, 1923

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

School record Marriage extract

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