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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000244

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of John JosephMacIntosh Sex Male

Date of Birth January 13, 1922 Place of Birth FlorenceCounty of Cape Breton

Name of Father Daniel MacIntosh MAIDEN NAME of Mother Mary MacPherson

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

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

Occupation of Father at Birth of child Miner Place of birth of Father Big Pond, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Mary MacIntosh Address of Applicant Butts Street, Sydney Mines Date 2 May 1959

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of John JosephMacIntosh

Born at Florence in the County of Cape Breton

That John JosephMacIntosh Whose Birth is sought to be registered was

born at Florence Cape Breton County on January 13, 1922

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

I am completely aware of the facts of birth of John Joseph MacIntosh as I am the mother of this man - also please be informed that the church baptism register is in error where is states the prefix to the surname as "Mc"

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