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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100023

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of DavidMacDonald Sex Male

Date of Birth November 21, 1921 Place of Birth DominionCounty of Cape Breton

Name of Father Dan K. MacDonald MAIDEN NAME of Mother Martha E. Hicks

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

Residence of Father when child was born 187 Church St. Dominion Present address of Father deceased

Occupation of Father at Birth of child Coal Miner Place of birth of Father Louisbourg

Race Name and present address of Physician in attendance at birth

Signature of Applicant David A. MacDonald Address of Applicant 106 Shaft St. Dominion Date July 27, 1983

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of DavidMacDonald

Born at Dominion in the County of Cape Breton

That DavidMacDonald Whose Birth is sought to be registered was

born at Dominion Cape Breton County on November 21, 1921

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

I have been searching through Church records and from the Census and National Registration records check. I have confirmed the date to be correct. Fees have been prepaid

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