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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000863

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Dorothy FrancesRoyer Sex Female

Date of Birth March 21, 1923 Place of Birth Eastern PassageCounty of Halifax

Name of Father Nelson Royer MAIDEN NAME of Mother Mabel Elsie Hall

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

Residence of Father when child was born Nova Scotia Present address of Father Deceased

Occupation of Father at Birth of child Army Place of birth of Father Sutton, Quebec

Race Name and present address of Physician in attendance at birth

Signature of Applicant Dorothy Royer-Dergon Address of Applicant 325 Bell, Apt 3, Cowansville, Quebec, J2K 3C9 Date 14 June 1983

Relationship of Applicant to child is the child

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Dorothy FrancesRoyer

Born at Eastern Passage in the County of Halifax

That Dorothy FrancesRoyer Whose Birth is sought to be registered was

born at Eastern Passage Halifax County on March 21, 1923

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

I am Dorothy Frances Royer

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