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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000768

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Ian KennethMacKenzie Sex Male

Date of Birth February 2, 1923 Place of Birth GairlochCounty of Pictou

Name of Father Hector F. MacKenzie MAIDEN NAME of Mother Georgina Johnson

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

Residence of Father when child was born New Gairloch Pictou Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Farmer Place of birth of Father New Gairloch, Pictou Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Ian Kenneth MacKenzie Address of Applicant RR #2, West River Station, Pictou Co., NS Date 27 June 1979

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Ian KennethMacKenzie

Born at Gairloch in the County of Pictou

That Ian KennethMacKenzie Whose Birth is sought to be registered was

born at Gairloch Pictou County on February 2, 1923

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

School register of 1931 & 1933

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