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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000498

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary JaneMacIntyre Sex Female

Date of Birth June 17, 1923 Place of Birth InvernessCounty of Inverness

Name of Father Joseph Archibald MacIntyre MAIDEN NAME of Mother Mary Anne MacDonald

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

Residence of Father when child was born Inverness Present address of Father Deceased

Occupation of Father at Birth of child Coal Miner Place of birth of Father Stillwater, Minnesota, USA

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mary Jane MacIntyre Address of Applicant 59 MacLeod Street, Sydney, Cape Breton Co., NS Date 28 September 1974

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary JaneMacIntyre

Born at Inverness in the County of Inverness

That Mary JaneMacIntyre Whose Birth is sought to be registered was

born at Inverness Inverness County on June 17, 1923

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

Family record - date of birth 17 June 1923 - place: Inverness Anne MacDonald, Aunt (Chisholm) Catherine Ann MacDonald, Aunt (MacMaster)

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