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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000730

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Edward JeanGautier Sex Male

Date of Birth November 24, 1924 Place of Birth SydneyCounty of Cape Breton

Name of Father Edward Francis Gautier MAIDEN NAME of Mother Mary Marcellin Burt

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 30 Sky Way Drive, Westmount, Cape Breton Co., NS

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mary Gautier Address of Applicant 46 Maple Ridge Drive, Sydney, Cape Breton Co., NS Date 23 March 1982

Relationship of Applicant to child Aunt

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Edward JeanGautier

Born at Sydney in the County of Cape Breton

That Edward JeanGautier Whose Birth is sought to be registered was

born at Sydney Cape Breton County on November 24, 1924

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

Based on baptismal and birth certificate he made known to me at my office Baptismal & parents' marriage shows surname as Gautier

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