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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000091

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of John AubreyMcKenzie Sex Male

Date of Birth October 20, 1923 Place of Birth Brenton Street, DartmouthCounty of Halifax

Name of Father William Stanley McKenzie MAIDEN NAME of Mother Ellen Agnes Craig

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

Residence of Father when child was born Brenton Street Dartmouth Halifax Co. Ns Present address of Father Imperoyal, Halifax Co., NS

Occupation of Father at Birth of child Truck Driver Place of birth of Father Eastern Passage, Halifax Co. NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Ellen Agnes McKenzie Address of Applicant Imperoyal, Halifax Co., NS Date 4 April 1949

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of John AubreyMcKenzie

Born at Brenton Street, Dartmouth in the County of Halifax

That John AubreyMcKenzie Whose Birth is sought to be registered was

born at Brenton Street, Dartmouth Halifax County on October 20, 1923

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

By certified statement from Dr. H. A. Payzant who was in attendance (certified statement attached). I am the mother, Ellen Agnes McKenzie.

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