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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000156

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Albert GordonMacKenzie Sex Male

Date of Birth December 29, 1922 Place of Birth North SydneyCounty of Cape Breton

Name of Father Daniel C. MacDenzie MAIDEN NAME of Mother Marion A. Appleby

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

Residence of Father when child was born Beech Street, North Sydney, Cape Breton Present address of Father Beech Street, North Sydney, Cape Breton

Occupation of Father at Birth of child Motorman Place of birth of Father Boularderie, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant Daniel C. MacKenzie Address of Applicant North Sydney, Cape Breton Date 15 April 1953

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Albert GordonMacKenzie

Born at North Sydney in the County of Cape Breton

That Albert GordonMacKenzie Whose Birth is sought to be registered was

born at North Sydney Cape Breton County on December 29, 1922

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

I am his father and was present at home when the said Albert Gordon MacKenzie was born.

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