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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700346

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Anna GertrudeMacCormack Sex Female

Date of Birth November 15, 1919 Place of Birth New WaterfordCounty of Cape Breton

Name of Father Peter MacCormack MAIDEN NAME of Mother Mary Loretta Petrie

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

Residence of Father when child was born New Waterford Present address of Father

Occupation of Father at Birth of child Miner Place of birth of Father Bridgeport

Race Name and present address of Physician in attendance at birth Dr. A.W. Miller

Signature of Applicant Mary Loretta MacCormack Address of Applicant New Waterford Date 27 November 1919

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Anna GertrudeMacCormack

Born at New Waterford in the County of Cape Breton

That Anna GertrudeMacCormack Whose Birth is sought to be registered was

born at New Waterford Cape Breton County on November 15, 1919

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

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