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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000483

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Kathleen CarmelMacDonald Sex Female

Date of Birth March 28, 1921 Place of Birth Glace BayCounty of Cape Breton

Name of Father Vincent MacDonald MAIDEN NAME of Mother Margaret Murphy

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

Residence of Father when child was born 13 Reserve St. Glace Bay Present address of Father deceased

Occupation of Father at Birth of child Salesman Place of birth of Father East Bay

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

Signature of Applicant Mrs. Kathleen Jukes Address of Applicant 1002 Hedge Dr. Mississauga, Ontario Date December 28, 1971

Relationship of Applicant to child n/a

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Kathleen CarmelMacDonald

Born at Glace Bay in the County of Cape Breton

That Kathleen CarmelMacDonald Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on March 28, 1921

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

I am the person who was born on the 28th of March 1921, the evidence of such birth being shown on Certification of Baptism, dated 29th April 1944, on which document I am shown as Catherine Carmel, but since birth, have been known as Kathleen Carmel and am now married and my name is now Kathleen Carmel Jukes.

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