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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90501564

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth October 9, 1920 Place of Birth HalifaxCounty of Halifax

Name of Father Daniel Wilbert McInnis MAIDEN NAME of Mother Mary Catherine Donahue

Residence of Father when child was born 2 1/2 South Clifton St., Halifax Present address of Father -

Occupation of Father at Birth of child Male Nurse Place of birth of Father Sheet Harbour, Halifax Co.

Race White Name and present address of Physician in attendance at birth Dr. MacKacy, Halifax

Signature of Applicant Mary Helen McInnis Address of Applicant 197 Hamilton Street, Dorchester, Massachusetts, USA Date 12 May 1939

Relationship of Applicant to child Same

AFFIDAVIT

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

Born at Halifax in the County of Halifax

That Mary HelenMcInnis Whose Birth is sought to be registered was

born at Halifax Halifax County on October 9, 1920

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

I know Mary Helen McInnis for 11 years and I know her to be a person of very good (?)

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