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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000642

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Donald RodneyMacKenzie Sex Male

Date of Birth August 1, 1923 Place of Birth Rear Balls CreekCounty of Cape Breton

Name of Father Donald John MacKenzie MAIDEN NAME of Mother Mary MacDonald

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

Residence of Father when child was born Rear Balls Creek Cape Breton Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Rear Balls Creek, Cape Breton Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Mary MacKenzie Address of Applicant Rear Balls Creek, Cape Breton Co., NS Date 24 April 1978

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Donald RodneyMacKenzie

Born at Rear Balls Creek in the County of Cape Breton

That Donald RodneyMacKenzie Whose Birth is sought to be registered was

born at Rear Balls Creek Cape Breton County on August 1, 1923

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

I am Donald Rodney MacKenzie's mother and I surely remember the day and date.

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