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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000091

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth April 15, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father John Donald MacLeod MAIDEN NAME of Mother Bessie Alice Samuels

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

Residence of Father when child was born Glace Bay, Cape Breton Present address of Father Deceased

Occupation of Father at Birth of child Meat Cutter Place of birth of Father Nova Scotia

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Bessie Alice Samuels MacLeod Address of Applicant 219 Dominion Street, Glace Bay, Cape Breton Date 23 September 1949

Relationship of Applicant to child Mother

AFFIDAVIT

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

Born at Glace Bay in the County of Cape Breton

That ArabelMacLeod Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on April 15, 1922

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

I am the mother of Arabel MacLeod. Enclosed find Glace Bay General Hospital birth certificate and also certificate of Doctor in attendance.

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