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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000114

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Henry FrancisMacIsaac Sex Male

Date of Birth December 2, 1921 Place of Birth Port HoodCounty of Inverness

Name of Father Daniel MacIsaac MAIDEN NAME of Mother Martha Dorey

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

Residence of Father when child was born Port Hood Present address of Father dead

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

Race Canadian Name and present address of Physician in attendance at birth

Signature of Applicant Freda MacIsaac Address of Applicant Rockingham Date September 2, 1949

Relationship of Applicant to child Wife

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Henry FrancisMacIsaac

Born at Port Hood in the County of Inverness

That Henry FrancisMacIsaac Whose Birth is sought to be registered was

born at Port Hood Inverness County on December 2, 1921

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

Enclosing Baptismal certificate attached

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