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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000217

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth May 19, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father John MacInnis MAIDEN NAME of Mother Mary Ann MacInnis

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

Residence of Father when child was born Reserve Street, Glace Bay, Cape Breton Present address of Father 233 Fraser Street, Glace Bay, Cape Breton

Occupation of Father at Birth of child Miner Place of birth of Father Port Morien, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mary Ann MacInnis Address of Applicant 233 Fraser Street, Glace Bay, Cape Breton Date 14 November 1956

Relationship of Applicant to child Mother

AFFIDAVIT

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

Born at Glace Bay in the County of Cape Breton

That ChristinaMacInnis Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on May 19, 1922

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

I am her mother. Baptismal certificate attached.

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