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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100143

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth June 28, 1922 Place of Birth LennoxCounty of Antigonish

Name of Father Ronald H. MacGillivray MAIDEN NAME of Mother Mary Anne MacDougall

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

Residence of Father when child was born Lennox, Antigonish Present address of Father

Occupation of Father at Birth of child Place of birth of Father Lennox, Antigonish

Race Name and present address of Physician in attendance at birth

Signature of Applicant Katherine Maloney Address of Applicant 10 Park Lane, Antigonish, B2G 1N5 Date 4 August 1998

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Lennox in the County of Antigonish

That KatherineMacGillivray Whose Birth is sought to be registered was

born at Lennox Antigonish County on June 28, 1922

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

I have a certificate of birth and baptism and we have always known my birth date.

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