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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000626

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Dorothy AgnesMacMurtery Sex Female

Date of Birth March 1, 1922 Place of Birth MargaretsvilleCounty of Annapolis

Name of Father Alvah MacMurtery MAIDEN NAME of Mother Isabelle Gibson MacMurtery

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

Residence of Father when child was born Margaretsville, Annapolis Present address of Father Deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Margaretsville, Annapolis

Race Name and present address of Physician in attendance at birth

Signature of Applicant Dorothy A. Smith Address of Applicant 254 Commercial Street, Middleton, Annapolis Date 10 March 1977

Relationship of Applicant to child for self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Dorothy AgnesMacMurtery

Born at Margaretsville in the County of Annapolis

That Dorothy AgnesMacMurtery Whose Birth is sought to be registered was

born at Margaretsville Annapolis County on March 1, 1922

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

Information as contained in family papers as attached

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