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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700310

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Katherine FlorenceMacInnis Sex Female

Date of Birth November 9, 1919 Place of Birth Glace BayCounty of Cape Breton

Name of Father John Alexander MacInnis MAIDEN NAME of Mother Sarah Elizabeth MacRury

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

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

Occupation of Father at Birth of child Railway conductor Place of birth of Father Mira

Race Name and present address of Physician in attendance at birth F.W. Green

Signature of Applicant John Alexander MacInnis Address of Applicant Glace Bay Date 28 November 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Katherine FlorenceMacInnis

Born at Glace Bay in the County of Cape Breton

That Katherine FlorenceMacInnis Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on November 9, 1919

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

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