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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91600144

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Agnes CatherineMacLeod Sex Female

Date of Birth August 20, 1923 Place of Birth Framboise IntervaleCounty of Richmond

Name of Father John H. MacLeod MAIDEN NAME of Mother Sarah McKillop

Residence of Father when child was born Framboise Intervale, Richmond Co., NS Present address of Father Framboise Intervale, Richmond Co., NS

Occupation of Father at Birth of child Farmer Place of birth of Father Framboise Intervale, Richmond Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Sarah MacLeod Address of Applicant Framboise Intervale, Richmond Co., NS Date 13 November 1941

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Agnes CatherineMacLeod

Born at Framboise Intervale in the County of Richmond

That Agnes CatherineMacLeod Whose Birth is sought to be registered was

born at Framboise Intervale Richmond County on August 20, 1923

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

The entry in the family bible reads as follows: "Agnes Catherine MacLeod, born August 20, 1923"

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