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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000903

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Florence ElizabethMacDonald Sex Female

Date of Birth January 30, 1920 Place of Birth Pictou IslandCounty of Pictou

Name of Father John W.  MacDonald MAIDEN NAME of Mother Ewena MacDonald

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

Residence of Father when child was born Pictou Island Present address of Father deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Pictou Island

Race Name and present address of Physician in attendance at birth

Signature of Applicant Florence E. Forbes Address of Applicant River John Date April 18, 1978

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Florence ElizabethMacDonald

Born at Pictou Island in the County of Pictou

That Florence ElizabethMacDonald Whose Birth is sought to be registered was

born at Pictou Island Pictou County on January 30, 1920

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

Extract from Marriage Extract from Church Record

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