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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000563

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of SamuelMacDonald Sex Male

Date of Birth September 6, 1923 Place of Birth Meisner SectionCounty of Lunenburg

Name of Father Samuel MacDonald MAIDEN NAME of Mother Ella May Kaizer

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

Residence of Father when child was born Meisner Section Lunenburg Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Wood Boss Place of birth of Father Liscomb Mills, Guysborough Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Samuel MacDonald Address of Applicant RR #3, New Germany, Lunenburg Co., NS Date 26 April 1976

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of SamuelMacDonald

Born at Meisner Section in the County of Lunenburg

That SamuelMacDonald Whose Birth is sought to be registered was

born at Meisner Section Lunenburg County on September 6, 1923

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

School records Marriage records

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