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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000616

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Eulalia AlfreidaGrace Sex Female

Date of Birth December 17, 1924 Place of Birth Reserve MinesCounty of Cape Breton

Name of Father Patrick Grace MAIDEN NAME of Mother Elizabeth Whalen

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

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

Occupation of Father at Birth of child Coal Miner Place of birth of Father Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Eulalia Alfreida Grace Address of Applicant 356 13th Street, New Waterford, Cape Breton Co., NS Date 2 March 1979

Relationship of Applicant to child Same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Eulalia AlfreidaGrace

Born at Reserve Mines in the County of Cape Breton

That Eulalia AlfreidaGrace Whose Birth is sought to be registered was

born at Reserve Mines Cape Breton County on December 17, 1924

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

I am the person concerned and am attaching a certificate of Birth and Baptism attesting to my birth on December 17th, 1924, signed and sealed by Father J.J. Tompkins, Parish Priest of Reserve Mines.

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