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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000763

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of HaroldBodechon Sex Male

Date of Birth April 4, 1924 Place of Birth ThorburnCounty of Pictou

Name of Father Gustave Bodechon MAIDEN NAME of Mother Elsie May King

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

Residence of Father when child was born Present address of Father

Occupation of Father at Birth of child Place of birth of Father

Race Name and present address of Physician in attendance at birth

Signature of Applicant Harold Gustave Bodechon Address of Applicant Newcastel Bridge, Queens Co., New Brunswick Date 9 December 1980

Relationship of Applicant to child Applicant is child

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of HaroldBodechon

Born at Thorburn in the County of Pictou

That HaroldBodechon Whose Birth is sought to be registered was

born at Thorburn Pictou County on April 4, 1924

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

My birthday was celebrated on April 4th and my parents told me that was when I was born. My mother made a declaration on the National life Assurance Company of Canada form attached stating the date of my birth.

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