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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000659

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of EarleMacInnis Sex Male

Date of Birth October 31, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father Ronald MacInnis MAIDEN NAME of Mother Sarah MacDonald

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 Dominion Coal Company employee Place of birth of Father Mira, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant Earle MacInnis Address of Applicant RR #2, Marion Bridge, Cape Breton Date 26 October 1977

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of EarleMacInnis

Born at Glace Bay in the County of Cape Breton

That EarleMacInnis Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on October 31, 1922

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

Statement from Glace Bay School Superintendent (Mr. Donald Fergusson). Glace Bay General Hospital Medical Record Librarian (1952 - Diane Pemberton)

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