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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000309

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Cecile DoraRomard Sex Female

Date of Birth September 14, 1924 Place of Birth CheticampCounty of Inverness

Name of Father Victor Romard MAIDEN NAME of Mother Josephine LeBlanc

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 Mechanical Enginer Place of birth of Father Cheticamp, Inverness Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Cecile Dora Romard Address of Applicant 6157 Willow Street, Halifax, NS Date 18 April 1968

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Cecile DoraRomard

Born at Cheticamp in the County of Inverness

That Cecile DoraRomard Whose Birth is sought to be registered was

born at Cheticamp Inverness County on September 14, 1924

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

Information received from parents Baptism certificate

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