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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000411

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Russell Francis GeorgePoirier Sex Male

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

Name of Father Delphin Poirier MAIDEN NAME of Mother Rachel Bruce

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 Pipe Fitter Place of birth of Father Cheticamp, Inverness Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Rachel Poirier Address of Applicant 52 Alexander Street, Glace Bay, Cape Breton Co., NS Date 24 July 1973

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Russell Francis GeorgePoirier

Born at Glace Bay in the County of Cape Breton

That Russell Francis GeorgePoirier Whose Birth is sought to be registered was

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

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

I remember when Russell was born

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