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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000777

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Dan AlexanderMacDonald Sex Male

Date of Birth October 21, 1923 Place of Birth InvernessCounty of Inverness

Name of Father John MacDonald MAIDEN NAME of Mother Mary Kennedy

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

Residence of Father when child was born Inverness Ns Present address of Father Deceased

Occupation of Father at Birth of child Police Force Place of birth of Father Port Hood, Inverness Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Dan Alexander MacDonald Address of Applicant 54 Weir Avenue South, Date 22 April 1980

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Dan AlexanderMacDonald

Born at Inverness in the County of Inverness

That Dan AlexanderMacDonald Whose Birth is sought to be registered was

born at Inverness Inverness County on October 21, 1923

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

I am two years older than my brother Dan Alexander MacDonald and I agree with the details contained in the certificate of baptism which is submitted with this application.

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