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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100031

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of MaryMacDonald Sex Female

Date of Birth October 29, 1921 Place of Birth SydneyCounty of Cape Breton

Name of Father William Errol MacDonald MAIDEN NAME of Mother Elizabeth McIntyre

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

Residence of Father when child was born Sydney Present address of Father deceased

Occupation of Father at Birth of child Place of birth of Father St. John's, Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mary MacDonald Lubentrott Address of Applicant 10365 So. Drake Chicago, Illinois, USA Date August 1983

Relationship of Applicant to child I am requesting a copy of my own Birth Certificate

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That MaryMacDonald Whose Birth is sought to be registered was

born at Sydney Cape Breton County on October 29, 1921

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

My parents told me where and when I was born. I have a copy of a baptismal Certificate from the Church where I was baptised on October 30, 1921. A copy of which I sent to you. I am naturalized Citizen of the USA entering from Niagara Falls on Oct. 21 1925 at the age of four years.

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