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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000681

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Jennie LoisKaiser Sex Female

Date of Birth June 6, 1920 Place of Birth Port BickertonCounty of Guysborough

Name of Father Jacob C. Kaiser MAIDEN NAME of Mother Jane Avery

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

Residence of Father when child was born Port Bickerton Present address of Father deceased

Occupation of Father at Birth of child Carpenter Place of birth of Father Port Bickerton

Race White Name and present address of Physician in attendance at birth Dr. MacIsaac, deceased

Signature of Applicant Jennie MacDonald Address of Applicant Sydney Date May 2, 1974

Relationship of Applicant to child same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Jennie LoisKaiser

Born at Port Bickerton in the County of Guysborough

That Jennie LoisKaiser Whose Birth is sought to be registered was

born at Port Bickerton Guysborough County on June 6, 1920

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

I am the sister of the applicant. - Doris Hunt

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