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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000381

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Annie JaneMacKay Sex Female

Date of Birth June 27, 1923 Place of Birth Upper NorthfieldCounty of Lunenburg

Name of Father Jason MacKay MAIDEN NAME of Mother Sadie Wolfe

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

Residence of Father when child was born Upper Northfield Lunenburg Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Upper Northfield, Lunenburg Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Annie Jane Address of Applicant MacKay Date Pinehurst, Lunenburg Co., NS

Relationship of Applicant to child 6 April 1970

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Annie JaneMacKay

Born at Upper Northfield in the County of Lunenburg

That Annie JaneMacKay Whose Birth is sought to be registered was

born at Upper Northfield Lunenburg County on June 27, 1923

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

Surname Mackie on Baptism certificate in error, correct surname MacKay is on her marriage certificate and also on parent' marriage certificate.

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