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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000647

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Shirley AlandynMacDonald Sex Female

Date of Birth October 18, 1922 Place of Birth AvonportCounty of Kings

Name of Father Russell Edward MacDonald MAIDEN NAME of Mother Mary Elizabeth Holmes

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

Residence of Father when child was born Avonport, Kings Present address of Father Avonport, Kings

Occupation of Father at Birth of child Farmer Place of birth of Father Falmouth, Hants

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Shirley A. Burgess Address of Applicant RSB, 30A, RR #2, Bedford, Halifax Date 23 August 1977

Relationship of Applicant to child myself

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Shirley AlandynMacDonald

Born at Avonport in the County of Kings

That Shirley AlandynMacDonald Whose Birth is sought to be registered was

born at Avonport Kings County on October 18, 1922

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

Entries in Family bible leaflet and the sworn declaration of the applicant. Marriage extract.

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