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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000850

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Anna DorothyGouchie Sex Female

Date of Birth August 7, 1923 Place of Birth AmherstCounty of Cumberland

Name of Father Archie Gouchie MAIDEN NAME of Mother Isabell B. McDonald

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

Residence of Father when child was born Nippan Cumberland Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Farmer Place of birth of Father St. Andrews, New Brunswick

Race Name and present address of Physician in attendance at birth

Signature of Applicant Anna Dorothy Leblanc Gouchie Address of Applicant 7 Stanley Street, Amherst, Cumberland Co., NS Date 3 March 1983

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Anna DorothyGouchie

Born at Amherst in the County of Cumberland

That Anna DorothyGouchie Whose Birth is sought to be registered was

born at Amherst Cumberland County on August 7, 1923

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

Church certificate of birth and baptism at St. Charles Church, Amherst, NS on November 9th, 1923

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