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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000312

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Andrea LucinaMcIntyre Sex Female

Date of Birth September 7, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father Angus McIntyre MAIDEN NAME of Mother Annie Jane Doucette

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 Stationary Electrical Engineer Place of birth of Father Glace Bay, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Donald Holder Address of Applicant 54 Lombardy Crescent, Scarborough, Ontario Date 16 July 1964

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Andrea LucinaMcIntyre

Born at Glace Bay in the County of Cape Breton

That Andrea LucinaMcIntyre Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on September 7, 1922

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

X-ray certificate dated 4 August 1941. Baptismal certificate of myself.

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