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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000311

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Gladys PearlMcKeigan Sex Female

Date of Birth December 2, 1921 Place of Birth SydneyCounty of Cape Breton

Name of Father Purves MacKeigan MAIDEN NAME of Mother Mary Grace Sharpe

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

Residence of Father when child was born Sydney Mines Present address of Father Sydney Mines

Occupation of Father at Birth of child Electrician Place of birth of Father Sydney Mines

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

Signature of Applicant Gladys Pearl Corby Address of Applicant 41 Faubert Dr. Chatham, Ontario Date October 18, 1962

Relationship of Applicant to child Same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Gladys PearlMcKeigan

Born at Sydney in the County of Cape Breton

That Gladys PearlMcKeigan Whose Birth is sought to be registered was

born at Sydney Cape Breton County on December 2, 1921

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

I am the applicant for registration of my own birth and I'm sure my date of birth is as above stated.

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