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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000057

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Irene ClythroeMacKinnon Sex Female

Date of Birth June 7, 1921 Place of Birth East LakeCounty of Inverness

Name of Father David  MacKinnon MAIDEN NAME of Mother Annie Butterworth

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

Residence of Father when child was born East Lake Ainslie Present address of Father East Lake Ainslie

Occupation of Father at Birth of child Farming Place of birth of Father East Lake Ainslie

Race Scottish Name and present address of Physician in attendance at birth Dr. H. MacKinnon

Signature of Applicant Mrs. Annie MacKinnon Address of Applicant East Lake Ainslie Date August 16, 1947

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Irene ClythroeMacKinnon

Born at East Lake in the County of Inverness

That Irene ClythroeMacKinnon Whose Birth is sought to be registered was

born at East Lake Inverness County on June 7, 1921

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

I am her Mother

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