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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000703

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Dorothy JaneMcCulley Sex Female

Date of Birth March 8, 1923 Place of Birth Baxters HarbourCounty of Kings

Name of Father George Nelson McCully MAIDEN NAME of Mother Alice Jane Schofield

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

Residence of Father when child was born Baxters Harbour Kings Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Arlington, Kings Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Dorothy J. Schofield Address of Applicant RR #5, Canning, Kings Co., NS Date 17 February 1979

Relationship of Applicant to child Same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Dorothy JaneMcCulley

Born at Baxters Harbour in the County of Kings

That Dorothy JaneMcCulley Whose Birth is sought to be registered was

born at Baxters Harbour Kings County on March 8, 1923

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

Family birth record - enclosed Married on May 24, 1941, Canning, NS Census record

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