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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000675

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth November 18, 1923 Place of Birth BoulardarieCounty of Cape Breton

Name of Father Michael Gillis MAIDEN NAME of Mother Florence MacIntyre

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

Residence of Father when child was born Rr Bras D'Or Present address of Father Deceased

Occupation of Father at Birth of child Farmer Place of birth of Father RR #1, Bras d'Or, Cape Breton Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mary Sarah Gillis Williams Address of Applicant RR #1, Bras d'Or, Cape Breton Co., NS Date 31 August 1978

Relationship of Applicant to child Own application

AFFIDAVIT

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

Born at Boulardarie in the County of Cape Breton

That Mary SarahGillis Whose Birth is sought to be registered was

born at Boulardarie Cape Breton County on November 18, 1923

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

Recorded in the family book of records

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