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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700121

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Alice LouiseMacouly Sex Female

Date of Birth December 16, 1919 Place of Birth Glace BayCounty of Cape Breton

Name of Father Robert Archibald Macouly MAIDEN NAME of Mother Adelina Johnson

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

Residence of Father when child was born Glace Bay Present address of Father McKays Corner

Occupation of Father at Birth of child Fuel inspector Place of birth of Father Port Morien

Race Name and present address of Physician in attendance at birth Dr. Daniel McNeil

Signature of Applicant Robert Archibald Macaulay Address of Applicant McKays Corner, Glace Bay Date 26 December 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Alice LouiseMacouly

Born at Glace Bay in the County of Cape Breton

That Alice LouiseMacouly Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on December 16, 1919

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

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