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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100152

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of BernardMacDonald Sex

Date of Birth January 28, 1920 Place of Birth AntigonishCounty of Antigonish

Name of Father John Charles MacDonald MAIDEN NAME of Mother Florence McLellan

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

Residence of Father when child was born Addington Forks, Antigonish Co. Present address of Father

Occupation of Father at Birth of child Place of birth of Father Londonderry, Colchester Co.

Race Name and present address of Physician in attendance at birth Dr. R.F. McDonald, Addington Forks

Signature of Applicant Mrs. Florence MacDonald Address of Applicant Date January 30, 1920

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of BernardMacDonald

Born at Antigonish in the County of Antigonish

That BernardMacDonald Whose Birth is sought to be registered was

born at Antigonish Antigonish County on January 28, 1920

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

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