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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000621

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Annie JosephineGillis Sex Female

Date of Birth January 19, 1922 Place of Birth South West MargareeCounty of Inverness

Name of Father Angus A. Gillis MAIDEN NAME of Mother Elizabeth Ann MacDonald

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

Residence of Father when child was born South West Margaree, Inverness Present address of Father Deceased

Occupation of Father at Birth of child Farmer Place of birth of Father South West Margaree, Inverness

Race Name and present address of Physician in attendance at birth

Signature of Applicant Annie J. Gillis Address of Applicant RR #1, Margaree Harbour, Inverness Date 19 January 1977

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Annie JosephineGillis

Born at South West Margaree in the County of Inverness

That Annie JosephineGillis Whose Birth is sought to be registered was

born at South West Margaree Inverness County on January 19, 1922

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

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