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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000333

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Doris BerniceMcGrath Sex Female

Date of Birth November 5, 1923 Place of Birth Victoria BeachCounty of Annapolis

Name of Father Samuel McGrath MAIDEN NAME of Mother  Ellis

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

Residence of Father when child was born Victoria Beach Annapolis Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Deckhand Place of birth of Father Victoria Beach, Annapolis Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Doris Bernice Rackley Address of Applicant 16 McKenna Crescent, Saint John, New Brunswick Date 19 January 1968

Relationship of Applicant to child Same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Doris BerniceMcGrath

Born at Victoria Beach in the County of Annapolis

That Doris BerniceMcGrath Whose Birth is sought to be registered was

born at Victoria Beach Annapolis County on November 5, 1923

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

On information received from my parents while living

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