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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100132

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of John WilliamMacDonald Sex Male

Date of Birth July 16, 1921 Place of Birth New WaterfordCounty of Cape Breton

Name of Father Daniel MacDonald MAIDEN NAME of Mother Mary MacInnis

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

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

Occupation of Father at Birth of child Coal Mining Place of birth of Father Thorburn

Race Name and present address of Physician in attendance at birth

Signature of Applicant John William Macdonald Address of Applicant 259 Olive St. New Waterford Date October 30, 1985

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of John WilliamMacDonald

Born at New Waterford in the County of Cape Breton

That John WilliamMacDonald Whose Birth is sought to be registered was

born at New Waterford Cape Breton County on July 16, 1921

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

See attached baptismal Certificate My father and Mother told me I was born on the 16 July 1921 and I have used this date all of my lifetime, for example for school purpose, employment purposes etc.

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