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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000171

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Elizabeth MaryKennedy Sex Female

Date of Birth January 9, 1923 Place of Birth Glace BayCounty of Cape Breton

Name of Father Jacob Kennedy MAIDEN NAME of Mother Josephine Tobin

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

Residence of Father when child was born King Edward Street Glace Bay Cape Breton Co. Ns Present address of Father 566 Howe Street, Glace Bay, Cape Breton Co., NS

Occupation of Father at Birth of child Fireman Place of birth of Father Conception Bay, Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant William Roy Donovan Address of Applicant 20 Bilby Street, Halifax, NS Date 28 October 1953

Relationship of Applicant to child Husband

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Elizabeth MaryKennedy

Born at Glace Bay in the County of Cape Breton

That Elizabeth MaryKennedy Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on January 9, 1923

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

Baptismal certificate from St. Anne's Parish, Glace Bay, Cape Breton Co., NS attached to form.

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