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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000413

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary ClarissaMarchand Sex Female

Date of Birth October 16, 1924 Place of Birth Petit de GratCounty of Richmond

Name of Father Leonard Marchand MAIDEN NAME of Mother Bertha Samson

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

Residence of Father when child was born Petit de Grat, Richmond Co., NS Present address of Father Little Anse, Richmond Co., NS

Occupation of Father at Birth of child Chef Place of birth of Father Petit de Grat, Richmond Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Claire Birt Address of Applicant RR #3, Truro, Colchester Co., NS Date 25 January 1974

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary ClarissaMarchand

Born at Petit de Grat in the County of Richmond

That Mary ClarissaMarchand Whose Birth is sought to be registered was

born at Petit de Grat Richmond County on October 16, 1924

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

Baptismal

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