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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000698

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Arnold JamesMacIntosh Sex Male

Date of Birth September 12, 1923 Place of Birth StillwaterCounty of Guysborough

Name of Father Gordon MacIntosh MAIDEN NAME of Mother Marie Whidden

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

Residence of Father when child was born Stillwater Guysborough Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Stillwater, Guysborough Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Arnold MacIntosh Address of Applicant RR #2, Aspen, Guysborough Co., NS Date 21 December 1978

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Arnold JamesMacIntosh

Born at Stillwater in the County of Guysborough

That Arnold JamesMacIntosh Whose Birth is sought to be registered was

born at Stillwater Guysborough County on September 12, 1923

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

According to record of baptism

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