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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100095

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth December 12, 1922 Place of Birth Malignant CoveCounty of Antigonish

Name of Father Hugh MacGillvray MAIDEN NAME of Mother Catherine MacInnis

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

Residence of Father when child was born Malignant Cove, Antigonish Present address of Father Deceased

Occupation of Father at Birth of child Fisherman/Farmer Place of birth of Father Malignant Cove, Antigonish

Race Name and present address of Physician in attendance at birth

Signature of Applicant Agnes MacGillivray Address of Applicant Malignant Cove, Antigonish Date 15 July 1987

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Malignant Cove in the County of Antigonish

That AgnesMacGillvray Whose Birth is sought to be registered was

born at Malignant Cove Antigonish County on December 12, 1922

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

Certificate of birth and baptism from St. Margarets Parish, Arisaig, Antigonish county, Province of Nova Scotia

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