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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000233

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Charles Edward RussellMacKinnon Sex Male

Date of Birth June 5, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father Joseph McKinnon MAIDEN NAME of Mother Mary Gillis

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

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

Occupation of Father at Birth of child Miner Place of birth of Father East Bay, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant C. E. R. McKinnon Address of Applicant 411 Third Street, New Aberdeen, Glace Bay Date 26 May 1958

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Charles Edward RussellMacKinnon

Born at Glace Bay in the County of Cape Breton

That Charles Edward RussellMacKinnon Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on June 5, 1922

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

I always observed my birthday on June 5 and the year of my birth as 1922. I enclosed baptismal certificate showing I was baptized on June 11, 1922. Marriage record.

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