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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000174

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of AgnesMacDonald Sex Female

Date of Birth October 15, 1923 Place of Birth SydneyCounty of Cape Breton

Name of Father Joseph MacDonald MAIDEN NAME of Mother Annie Baldwin

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

Residence of Father when child was born Shore Road Sydney Cape Breton Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Coal Trimmer Place of birth of Father Grand Mira, Cape Breton Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Joseph Peck Address of Applicant 97 Matilda Street, Sydney, Cape Breton Co., NS Date 27 April 1954

Relationship of Applicant to child First Cousin

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That AgnesMacDonald Whose Birth is sought to be registered was

born at Sydney Cape Breton County on October 15, 1923

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

by certificate of baptism attached and I also remember the date on which the said Agnes MacDonald was born.

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