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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000721

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth December 13, 1923 Place of Birth SydneyCounty of Cape Breton

Name of Father   MAIDEN NAME of Mother Florence Spencer

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Present address of Father

Occupation of Father at Birth of child Place of birth of Father

Race Name and present address of Physician in attendance at birth

Signature of Applicant Pauline MacIntosh Address of Applicant PO Box 35, St. Andrew's, Antigonish Co., NS Date October 1978

Relationship of Applicant to child One and the same person

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That Mary PaulineSpencer Whose Birth is sought to be registered was

born at Sydney Cape Breton County on December 13, 1923

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

Baptismal certificate issued by Antigonish Diocesan Charities, Sydney, NS, and attached hereto.

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