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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000872

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of John AndrewMacLellan Sex Male

Date of Birth July 20, 1920 Place of Birth Big MarshCounty of Antigonish

Name of Father Malcolm A.  MacLellan MAIDEN NAME of Mother Florence Anne MacLellan

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

Residence of Father when child was born Big Marsh Present address of Father deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Big Marsh

Race Name and present address of Physician in attendance at birth

Signature of Applicant John Andrew MacLellan Address of Applicant Big Marsh Date October 31, 1977

Relationship of Applicant to child same person

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of John AndrewMacLellan

Born at Big Marsh in the County of Antigonish

That John AndrewMacLellan Whose Birth is sought to be registered was

born at Big Marsh Antigonish County on July 20, 1920

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

I attended at St. Mary's Parish, Maryvale, Antigonish County, and the church records indicate my birth on July 20, 1920, as evidenced by the attached Certificate of Birth and Baptism, marked as Schedule "A" to this Statutory Declaration

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