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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100009

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Gillivary MacKayRoss Sex Female

Date of Birth December 17, 1921 Place of Birth New GlasgowCounty of Pictou

Name of Father Hugh W. Ross MAIDEN NAME of Mother Mary G. Fraser

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

Residence of Father when child was born New Glasgow Present address of Father deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Blue Mountain

Race Name and present address of Physician in attendance at birth

Signature of Applicant Gillivary Ross Address of Applicant Box 628 New Glasgow Date April 20, 1983

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Gillivary MacKayRoss

Born at New Glasgow in the County of Pictou

That Gillivary MacKayRoss Whose Birth is sought to be registered was

born at New Glasgow Pictou County on December 17, 1921

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

Baptismal

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