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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000323

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Etta Leota MaeDixon Sex Female

Date of Birth August 3, 1921 Place of Birth SydneyCounty of Cape Breton

Name of Father Reginald Dixon MAIDEN NAME of Mother Hazel MacLeod

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

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

Occupation of Father at Birth of child Steel worker Place of birth of Father Amherst

Race English Name and present address of Physician in attendance at birth deceased

Signature of Applicant J. McMenemy Address of Applicant Dartmouth Date January 9, 1964

Relationship of Applicant to child Husband

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Etta Leota MaeDixon

Born at Sydney in the County of Cape Breton

That Etta Leota MaeDixon Whose Birth is sought to be registered was

born at Sydney Cape Breton County on August 3, 1921

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

Certificate of Baptism

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