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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000190

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Alice AnnShaw Sex Female

Date of Birth August 4, 1921 Place of Birth Sydney RiverCounty of Cape Breton

Name of Father Rodrick Alex Shaw MAIDEN NAME of Mother Sarah MacAskill

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

Residence of Father when child was born Sydney River Present address of Father 19 Blackett St. Glace Bay

Occupation of Father at Birth of child Blacksmith Place of birth of Father Mt. Auburn

Race Scottish Name and present address of Physician in attendance at birth Dr. Dan MacLeod

Signature of Applicant Sarah Shaw Address of Applicant 19 Blackett St. Glace Bay Date September 24, 1954

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Alice AnnShaw

Born at Sydney River in the County of Cape Breton

That Alice AnnShaw Whose Birth is sought to be registered was

born at Sydney River Cape Breton County on August 4, 1921

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

Record in Family Bible (and school record) I am her mother

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