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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000832

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth April 23, 1924 Place of Birth North SydneyCounty of Cape Breton

Name of Father Henry Dupont MAIDEN NAME of Mother Germaine Lecreux

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

Residence of Father when child was born North Sydney Present address of Father deceased

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Germain Dupont Address of Applicant Birch Grove Date Sept 18, 1985

Relationship of Applicant to child Mother

AFFIDAVIT

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

Born at North Sydney in the County of Cape Breton

That HenryDupont Whose Birth is sought to be registered was

born at North Sydney Cape Breton County on April 23, 1924

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

I am the mother and remember the facts

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