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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000262

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Clarke WeldonMacQuarrie Sex Male

Date of Birth July 14, 1923 Place of Birth Molega MinesCounty of Queens

Name of Father Neil Hector MacQuarrie MAIDEN NAME of Mother Jennie Matilda Nowe

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

Residence of Father when child was born Molega Mines Queens Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Lumberman Place of birth of Father Molega Mines, Queens Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Jennie MacQuarrie Address of Applicant Pleasant River, Queens Co., NS Date 14 January 1961

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Clarke WeldonMacQuarrie

Born at Molega Mines in the County of Queens

That Clarke WeldonMacQuarrie Whose Birth is sought to be registered was

born at Molega Mines Queens County on July 14, 1923

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

I am his mother and have personal knowledge of the date of his birth. Declaration of attending physicians wife as witness to the birth. School record & family bible record.

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