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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000599

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Gladys MayMacLeod Sex Female

Date of Birth April 30, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father George MacLeod MAIDEN NAME of Mother Victoria Virginia Collins

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 Coal Company Employee Place of birth of Father Prince Edward Island

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Gladys King Address of Applicant 20 O'Leary Avenue, Toronto, Ontario Date 12 January 1973

Relationship of Applicant to child Same person

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Gladys MayMacLeod

Born at Glace Bay in the County of Cape Breton

That Gladys MayMacLeod Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on April 30, 1922

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

Search of Primary School records; letter and certificate of Superintendent of Town of Glace Bay Schools are attached hereto as schedules A and B.

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