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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000269

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary AgnesMacKinnon Sex

Date of Birth January 12, 1920 Place of Birth BridgeportCounty of Cape Breton

Name of Father Lauchlin MacKinnon MAIDEN NAME of Mother Sarah MacLeod

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

Residence of Father when child was born Bridgeport Present address of Father Bridgeport

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

Race Scottish Name and present address of Physician in attendance at birth Dr. M.G. Tompkins, Glace Bay

Signature of Applicant Mary Agnes MacKinnon Address of Applicant Glace Bay Date November 23, 1956

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Bridgeport in the County of Cape Breton

That Mary AgnesMacKinnon Whose Birth is sought to be registered was

born at Bridgeport Cape Breton County on January 12, 1920

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

It Is the date of birth shown on the attached Certificate of Baptism and of Birth from the Parish of the Immaculate Conception, Bridgeport, C.B.

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