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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000319

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Duncan TheodoreBoutilier Sex Male

Date of Birth December 5, 1924 Place of Birth Glace BayCounty of Cape Breton

Name of Father Edward Boutilier MAIDEN NAME of Mother Elizabeth Daye

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

Residence of Father when child was born Glace Bay, Cape Breton Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Miner Place of birth of Father Gardiner Mines, Cape Breton Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant D. T. Boutilier Address of Applicant 183 Plummer Avenue, New Waterford, Cape Breton Co., NS Date 22 April 1969

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Duncan TheodoreBoutilier

Born at Glace Bay in the County of Cape Breton

That Duncan TheodoreBoutilier Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on December 5, 1924

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

Aunt of the person concerned (sister of his mother) and aware of fact from personal knowledge and close association with the family

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