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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100150

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth January 11, 1921 Place of Birth HalifaxCounty of Halifax

Name of Father Archable MacInnis MAIDEN NAME of Mother Annie Smith

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

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

Occupation of Father at Birth of child Miner Place of birth of Father Whiteburn Mines West Caledonia

Race Name and present address of Physician in attendance at birth

Signature of Applicant Eunice Fancie Address of Applicant Liverpool Date August 23, 1985

Relationship of Applicant to child Applicant is the child

AFFIDAVIT

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

Born at Halifax in the County of Halifax

That EuniceMacInnis Whose Birth is sought to be registered was

born at Halifax Halifax County on January 11, 1921

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

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