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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000763

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Dorothy AnnMacDonald Sex Female

Date of Birth December 8, 1920 Place of Birth Glace BayCounty of Cape Breton

Name of Father Clinton MacDonald MAIDEN NAME of Mother Elsie Wagner

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

Residence of Father when child was born Glace Bay Present address of Father deceased

Occupation of Father at Birth of child Mechanic Place of birth of Father St. Peter's

Race Name and present address of Physician in attendance at birth

Signature of Applicant Dorothy White Address of Applicant Sydney Date December 20, 1976

Relationship of Applicant to child same person

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Dorothy AnnMacDonald

Born at Glace Bay in the County of Cape Breton

That Dorothy AnnMacDonald Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on December 8, 1920

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

Hospital Birth Certificate (supplied)

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