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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100103

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Edward Allan JosephMacInnis Sex Male

Date of Birth April 17, 1922 Place of Birth North SydneyCounty of Cape Breton

Name of Father John MacInnis MAIDEN NAME of Mother Christine McIntyre

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

Residence of Father when child was born Glace Bay, Cape Breton Present address of Father Deceased

Occupation of Father at Birth of child Coal Miner Place of birth of Father Castle Bay, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant Edward MacInnis Address of Applicant 4870 Walkley, Apt 10, Montreal, Quebec Date November 1986

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Edward Allan JosephMacInnis

Born at North Sydney in the County of Cape Breton

That Edward Allan JosephMacInnis Whose Birth is sought to be registered was

born at North Sydney Cape Breton County on April 17, 1922

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

My old birth certificate was lost. The date of birth always appeared in copy and school records which have been lost with my birth certificate.

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