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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000349

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth December 10, 1923 Place of Birth SydneyCounty of Cape Breton

Name of Father William John Kennedy MAIDEN NAME of Mother Sadie Charlotte MacDonald

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

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

Occupation of Father at Birth of child Carpenter Place of birth of Father Estmere, Victoria Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Sadie C. Kennedy Address of Applicant 22 Dartmouth Place, Boston, Massachusetts Date 31 October 1967

Relationship of Applicant to child Mother

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That John MacDonaldKennedy Whose Birth is sought to be registered was

born at Sydney Cape Breton County on December 10, 1923

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

Declaration of Intention - NS Citizenship

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