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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000786

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of MargaretLong Sex Female

Date of Birth January 11, 1922 Place of Birth Bras D'OrCounty of Cape Breton

Name of Father George Long MAIDEN NAME of Mother Janie Cormier

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

Residence of Father when child was born Bras d'Or, Cape Breton Present address of Father Deceased

Occupation of Father at Birth of child Coal miner Place of birth of Father Point Tupper, Richmond

Race Name and present address of Physician in attendance at birth

Signature of Applicant Margaret Jessome Address of Applicant Bras d'Or, Cape Breton Date 1 December 1979

Relationship of Applicant to child One and the same person

AFFIDAVIT

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

Born at Bras D'Or in the County of Cape Breton

That MargaretLong Whose Birth is sought to be registered was

born at Bras D'Or Cape Breton County on January 11, 1922

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

1. Certificate of baptism already submitted 2. My parents told me so

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