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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91700139

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of FernieMacLeod Sex Male

Date of Birth September 13, 1923 Place of Birth InvernessCounty of Inverness

Name of Father Vance MacLeod MAIDEN NAME of Mother Elizabeth Jane Deagle

Residence of Father when child was born Inverness, NS Present address of Father Inverness, NS

Occupation of Father at Birth of child Electrician Place of birth of Father Parrsboro, Cumberland Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Vance MacLeod Address of Applicant Inverness, NS Date 20 April 1942

Relationship of Applicant to child Father

AFFIDAVIT

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

Born at Inverness in the County of Inverness

That FernieMacLeod Whose Birth is sought to be registered was

born at Inverness Inverness County on September 13, 1923

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

As the father of the said child, I was present in the home at the time of birth and the fact and date of birth are well know to me.

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