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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000903

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Anne CatherineMacIntyre Sex Female

Date of Birth December 29, 1922 Place of Birth DominionCounty of Cape Breton

Name of Father John MacIntyre MAIDEN NAME of Mother Isabelle Campbell

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

Residence of Father when child was born Dominion, Cape Breton, SN Present address of Father Deceased

Occupation of Father at Birth of child Coal Miner Place of birth of Father Reserve Mines, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant Anne Catherine Roper Address of Applicant 86 Wesley Street, Glace Bay, Cape Breton Date 28 July 1982

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Anne CatherineMacIntyre

Born at Dominion in the County of Cape Breton

That Anne CatherineMacIntyre Whose Birth is sought to be registered was

born at Dominion Cape Breton County on December 29, 1922

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

Class A evidence in the form of certificate of baptism and birth from records of Immaculate Conception Parish, Dominion. Nova Scotia

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