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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90600296

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Lillian MargaretMcBurnie Sex Female

Date of Birth September 25, 1921 Place of Birth TatamagoucheCounty of Colchester

Name of Father Sydney McBurnie MAIDEN NAME of Mother Mary McPherson

Residence of Father when child was born Tatamagouche, Colchester Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Tatamagouche, Colchester Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Mary McBurnie Address of Applicant Tatamagouche, Colchester Co., NS Date 18 May 1934

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Lillian MargaretMcBurnie

Born at Tatamagouche in the County of Colchester

That Lillian MargaretMcBurnie Whose Birth is sought to be registered was

born at Tatamagouche Colchester County on September 25, 1921

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

I am his mother

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