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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000151

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Zelie CelineRoach Sex Female

Date of Birth October 18, 1924 Place of Birth CheticampCounty of Inverness

Name of Father Louis John Roach MAIDEN NAME of Mother Rose Chiasson

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

Residence of Father when child was born Cheticamp, Inverness Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Labourer Place of birth of Father Cheticamp, Inverness Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Rose Roach Address of Applicant Plateau, Inverness Co., NS Date 30 December 1954

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Zelie CelineRoach

Born at Cheticamp in the County of Inverness

That Zelie CelineRoach Whose Birth is sought to be registered was

born at Cheticamp Inverness County on October 18, 1924

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

As mother to the child by my own knowledge and her church certificate

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