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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000589

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Roderick JohnMcKinnon Sex Male

Date of Birth December 3, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father Angus McKinnon MAIDEN NAME of Mother  Gillis

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 Carpenter Place of birth of Father Nova Scotia

Race Name and present address of Physician in attendance at birth

Signature of Applicant R. J. McKinnon Address of Applicant 70 Rodman Street, St. Catharines, Ontario Date 15 July 1976

Relationship of Applicant to child I am the child

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Roderick JohnMcKinnon

Born at Glace Bay in the County of Cape Breton

That Roderick JohnMcKinnon Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on December 3, 1922

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

I am the person whose birth is sought to be registered. I have examined and submitted my birth and baptismal certificate. My parents are deceased and my sister lives in the United States.

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