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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91700796

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Laurie BlairMacKinnon Sex Male

Date of Birth July 27, 1921 Place of Birth BruleCounty of Colchester

Name of Father Frank Sterling MacKinnon MAIDEN NAME of Mother Lily Winona Steveson

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

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Lily Winona MacKinnon Address of Applicant Brule, Colchester Co., NS Date 5 November 1943

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Laurie BlairMacKinnon

Born at Brule in the County of Colchester

That Laurie BlairMacKinnon Whose Birth is sought to be registered was

born at Brule Colchester County on July 27, 1921

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

I am the mother of the said Laurie Blair MacKinnon

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