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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700325

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of McKenzieAnnie Belle Sex Female

Date of Birth November 29, 1919 Place of Birth Glace BayCounty of Cape Breton

Name of Father Frank Dan McKenzie MAIDEN NAME of Mother Catherine Bell McLeod

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

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

Occupation of Father at Birth of child Miner Place of birth of Father Big Harbour Centre

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

Signature of Applicant Frank Dan McKenzie Address of Applicant New Aberdeen Date 26 December 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of McKenzieAnnie Belle

Born at Glace Bay in the County of Cape Breton

That McKenzieAnnie Belle Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on November 29, 1919

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

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