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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000545

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth July 7, 1923 Place of Birth Toney RiverCounty of Pictou

Name of Father Daniel Robert MacKenzie MAIDEN NAME of Mother Christina Bell Henderson

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

Residence of Father when child was born Toney River Present address of Father deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Toney River

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mary C. Cameron Address of Applicant 2 Weller Crescent, Maple Date October 28, 1975

Relationship of Applicant to child Applicant is one and the same

AFFIDAVIT

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

Born at Toney River in the County of Pictou

That Mary ChristinaMacKenzie Whose Birth is sought to be registered was

born at Toney River Pictou County on July 7, 1923

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

Certificate of Baptism recording date of birth as July 7, 1923 Family Bible which records date of birth as July 7, 1923

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