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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000737

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary CleophasMacDonald Sex Female

Date of Birth February 3, 1921 Place of Birth East BayCounty of Cape Breton

Name of Father Neil MacDonald MAIDEN NAME of Mother Katie McPherson

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

Residence of Father when child was born East Bay Present address of Father deceased

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Cleopha MacDonald McMahon Address of Applicant Box 216 Sydney Date March 2, 1978

Relationship of Applicant to child same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary CleophasMacDonald

Born at East Bay in the County of Cape Breton

That Mary CleophasMacDonald Whose Birth is sought to be registered was

born at East Bay Cape Breton County on February 3, 1921

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

My own personal knowledge

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