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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000767

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Flora MaryMcDonald Sex Female

Date of Birth December 30, 1921 Place of Birth Glace BayCounty of Cape Breton

Name of Father Arthur McDonald MAIDEN NAME of Mother Matilda Muise

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

Residence of Father when child was born Glace Bay Present address of Father Glace Bay

Occupation of Father at Birth of child Coal Miner Place of birth of Father Glace Bay

Race Name and present address of Physician in attendance at birth

Signature of Applicant Flora Mary McDonald Address of Applicant 1365 King St. W. Toronto, Ontario Date August 8, 1978

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Flora MaryMcDonald

Born at Glace Bay in the County of Cape Breton

That Flora MaryMcDonald Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on December 30, 1921

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

As told by my parents and confirmed by church records

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