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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

93602466

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Jessie MaryMcLeod Sex Female

Date of Birth July 10, 1906 Place of Birth Island RiverCounty of Richmond

Name of Father Donald John McLeod MAIDEN NAME of Mother Katie Sarah McLeod

Residence of Father when child was born Island River Present address of Father Deceased

Occupation of Father at Birth of child Carpenter Place of birth of Father Island River

Race Scottish Name and present address of Physician in attendance at birth

Signature of Applicant Katie Sarah McLeod Address of Applicant Island River Date 23 August 1926

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Jessie MaryMcLeod

Born at Island River in the County of Richmond

That Jessie MaryMcLeod Whose Birth is sought to be registered was

born at Island River Richmond County on July 10, 1906

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

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