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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000730

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of BurtonMacDonald Sex Male

Date of Birth March 19, 1923 Place of Birth Glace BayCounty of Cape Breton

Name of Father Norman Alexander MacDonald MAIDEN NAME of Mother Mary Ann McLeod

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

Residence of Father when child was born Glace Bay Cape Breton Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Coal Miner Place of birth of Father Glace Bay, Cape Breton Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant B. MacDonald Address of Applicant 20 Teesdale Place, Scarborough, Ontario Date 2 May 1979

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of BurtonMacDonald

Born at Glace Bay in the County of Cape Breton

That BurtonMacDonald Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on March 19, 1923

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

the Hospital certificate which you are now holding as Class "A" evidence, with a $3.00 credit.

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