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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000136

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Stephen JamesMacDougall Sex Male

Date of Birth June 5, 1921 Place of Birth Glace BayCounty of Cape Breton

Name of Father Joseph MacDougall MAIDEN NAME of Mother Mary Ellen Harte

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

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

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

Race White Name and present address of Physician in attendance at birth Dr. E.O. MacDonald

Signature of Applicant Stephen J. MacDougall Address of Applicant 56 Brookside St. Date February 8, 1951

Relationship of Applicant to child Same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Stephen JamesMacDougall

Born at Glace Bay in the County of Cape Breton

That Stephen JamesMacDougall Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on June 5, 1921

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

Baptismal record copied from original entry made sseven days after birth. I am his mother.

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