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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000441

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Jean ElizabethChisholm Sex Female

Date of Birth September 5, 1923 Place of Birth AntigonishCounty of Antigonish

Name of Father Angus Chisholm MAIDEN NAME of Mother Maria MacIsaac

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

Residence of Father when child was born Antigonish Ns Present address of Father Deceased

Occupation of Father at Birth of child Farming Place of birth of Father Antigonish, NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Jean Elizabeth Chisholm Address of Applicant 24 Neville Street, Sydney, Cape Breton Co., NS Date 17 August 1972

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Jean ElizabethChisholm

Born at Antigonish in the County of Antigonish

That Jean ElizabethChisholm Whose Birth is sought to be registered was

born at Antigonish Antigonish County on September 5, 1923

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

Jean Elizabeth Chisholm is my sister and I have seen her certificate of Baptism.

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