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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000953

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth May 21, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father Harry MacKenzie MAIDEN NAME of Mother Lillian MacLeod

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

Residence of Father when child was born Reserve Mines, Cape Breton Present address of Father Deceased

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Marjorie White Address of Applicant 144 Braemar Drive, Sydney, Cape Breton Date 19 September 1983

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Glace Bay in the County of Cape Breton

That MarjorieMacKenzie Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on May 21, 1922

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

I am her mother

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