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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100008

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Leah DorisCoombs Sex Female

Date of Birth March 5, 1923 Place of Birth SydneyCounty of Cape Breton

Name of Father Herbert Coombs MAIDEN NAME of Mother Annie Kelland

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

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

Occupation of Father at Birth of child Crane Operator Place of birth of Father St. John's, Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Leah Doris Coombs Address of Applicant 6145 Leger Blvd, Apt 43, Montreal North, Quebec Date 3 November 1987

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Leah DorisCoombs

Born at Sydney in the County of Cape Breton

That Leah DorisCoombs Whose Birth is sought to be registered was

born at Sydney Cape Breton County on March 5, 1923

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

As per copy of attached certificate of baptism

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