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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000771

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary EllenCormier Sex Female

Date of Birth July 27, 1924 Place of Birth SydneyCounty of Cape Breton

Name of Father James Cormier MAIDEN NAME of Mother Mary Ann Roache

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

Residence of Father when child was born Newfoundland Present address of Father Deceased

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Darlene Theriault Address of Applicant Lake Echo, Halifax Co., NS Date 12 January 1984

Relationship of Applicant to child Daughter in Law to be

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary EllenCormier

Born at Sydney in the County of Cape Breton

That Mary EllenCormier Whose Birth is sought to be registered was

born at Sydney Cape Breton County on July 27, 1924

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

Baptismal

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