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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

64500166

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Carson LeRoyMacGillvray Sex Male

Date of Birth November 18, 1919 Place of Birth Spensers IslandCounty of Cumberland

Name of Father Andrew Hood MacGillvray MAIDEN NAME of Mother Lucy Neta MacGillvray

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

Residence of Father when child was born Spencers Island Present address of Father

Occupation of Father at Birth of child Ship carpenter Place of birth of Father Spencers Island

Race Name and present address of Physician in attendance at birth Dr. Millard J. Fillmore

Signature of Applicant Lucy Netta MacGillvray Address of Applicant Spencers Island Date 13 December 1919

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Carson LeRoyMacGillvray

Born at Spensers Island in the County of Cumberland

That Carson LeRoyMacGillvray Whose Birth is sought to be registered was

born at Spensers Island Cumberland County on November 18, 1919

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

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