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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000630

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mildred EileenMacLeod Sex Female

Date of Birth November 28, 1922 Place of Birth DominionCounty of Cape Breton

Name of Father James Alexander MacvLeod MAIDEN NAME of Mother Edith Layte MacDonald

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

Residence of Father when child was born Dominion, Cape Breton Present address of Father 108 Webster Street, Sydney, Cape Breton

Occupation of Father at Birth of child Coal miner Place of birth of Father Dominion, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mildred E. Apblett Address of Applicant 108 Webster Street, Sydney, Cape Breton Date 5 May 1977

Relationship of Applicant to child applicant is the above named person

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mildred EileenMacLeod

Born at Dominion in the County of Cape Breton

That Mildred EileenMacLeod Whose Birth is sought to be registered was

born at Dominion Cape Breton County on November 28, 1922

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

Baptism certificate

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