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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000743

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Clarence BernardLandry Sex Male

Date of Birth September 30, 1924 Place of Birth SydneyCounty of Cape Breton

Name of Father Peter Charles Landry MAIDEN NAME of Mother Mildred M. Jollymore

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 Deceased

Occupation of Father at Birth of child Iron Worker ? Place of birth of Father River Bourgeois, Richmond Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Clarence B. Landry Address of Applicant RR #3, Site 8, Compartment 30, Sydney, Cape Breton Co., NS Date 10 February 1983

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Clarence BernardLandry

Born at Sydney in the County of Cape Breton

That Clarence BernardLandry Whose Birth is sought to be registered was

born at Sydney Cape Breton County on September 30, 1924

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

Certificate of baptism attached

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