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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100045

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of James FrancisMacNeil Sex Male

Date of Birth October 2, 1921 Place of Birth Glace BayCounty of Cape Breton

Name of Father   MAIDEN NAME of Mother Catherine MacNeil

Were the Parents married at the time of the Birth? No

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

Occupation of Father at Birth of child Place of birth of Father

Race Name and present address of Physician in attendance at birth

Signature of Applicant James MacNeil Address of Applicant 11 Railroad St. Sydney Date March 24, 1984

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of James FrancisMacNeil

Born at Glace Bay in the County of Cape Breton

That James FrancisMacNeil Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on October 2, 1921

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

This is my own birth

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