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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000315

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Daniel LavinPoirier Sex Male

Date of Birth November 4, 1924 Place of Birth Glace BayCounty of Cape Breton

Name of Father Henry J. Poirier MAIDEN NAME of Mother Catherine McDonald

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

Residence of Father when child was born Union Street, Glace Bay, Cape Breton Co., NS Present address of Father 5A Bruce Street, Glace Bay, Cape Breton Co., NS

Occupation of Father at Birth of child Repairman Place of birth of Father Richmond, Quebec

Race Name and present address of Physician in attendance at birth

Signature of Applicant Henry Poirier Address of Applicant 5A Bruce Street, Glace Bay, Cape Breton Co., NS Date 7 November 1968

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Daniel LavinPoirier

Born at Glace Bay in the County of Cape Breton

That Daniel LavinPoirier Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on November 4, 1924

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

I am his father. Also birth & baptismal certificate, St. Ann's Parish, Glace Bay, NS

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