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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000680

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary LouiseMacDonald Sex Female

Date of Birth March 3, 1922 Place of Birth InvernessCounty of Inverness

Name of Father Jack MacDonald MAIDEN NAME of Mother Minnie MacLellan

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

Residence of Father when child was born Inverness Present address of Father Deceased

Occupation of Father at Birth of child Place of birth of Father

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mary Louise Holota Address of Applicant 192 Rosewood Road, Hamilton, Ontario Date 17 February 1978

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary LouiseMacDonald

Born at Inverness in the County of Inverness

That Mary LouiseMacDonald Whose Birth is sought to be registered was

born at Inverness Inverness County on March 3, 1922

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

Church certificate of birth and baptism enclosed

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