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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000529

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Roger JohnRaoul Sex Male

Date of Birth October 12, 1924 Place of Birth SydneyCounty of Cape Breton

Name of Father Francis Peter Raoul MAIDEN NAME of Mother Jeanne LeRelique

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

Residence of Father when child was born Sydney, Cape Breton Co., NS Present address of Father 368 St. Peters Road, Sydney, Cape Breton Co., NS

Occupation of Father at Birth of child Steel Worker Place of birth of Father St. Pierre & Miquelon

Race Name and present address of Physician in attendance at birth

Signature of Applicant Roger John Raoul Address of Applicant 34 Sutherland Street, Sydney, Cape Breton Co., NS Date 29 January 1977

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Roger JohnRaoul

Born at Sydney in the County of Cape Breton

That Roger JohnRaoul Whose Birth is sought to be registered was

born at Sydney Cape Breton County on October 12, 1924

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

Enclosed certificate of birth & baptism

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