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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000041

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth February 27, 1922 Place of Birth West BranchCounty of Pictou

Name of Father Hugh Daniel MacKenzie MAIDEN NAME of Mother Jennie Marion MacKay

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

Residence of Father when child was born West Branch, Pictou Present address of Father Deceased

Occupation of Father at Birth of child Farmer Place of birth of Father West Branch, Pictou

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Hugh Daniel MacKenzie Address of Applicant West Branch, Pictou Date 14 August 1947

Relationship of Applicant to child Mother

AFFIDAVIT

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

Born at West Branch in the County of Pictou

That James HughMacKenzie Whose Birth is sought to be registered was

born at West Branch Pictou County on February 27, 1922

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

I am the mother of James Hugh MacKenzie, the person whose birth is sought to be registered

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