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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000885

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Lawrence AlexanderMacKenzie Sex Male

Date of Birth January 3, 1923 Place of Birth SydneyCounty of Cape Breton

Name of Father Alex S. MacKenzie MAIDEN NAME of Mother  MacInnis

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

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

Occupation of Father at Birth of child Carpenter Place of birth of Father Sydney, Cape Breton Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Lawrence A. MacKenzie Address of Applicant 95 Edgewood Drive, Sydney, Cape Breton Co., NS Date 27 February 1984

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Lawrence AlexanderMacKenzie

Born at Sydney in the County of Cape Breton

That Lawrence AlexanderMacKenzie Whose Birth is sought to be registered was

born at Sydney Cape Breton County on January 3, 1923

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

Certificate of birth from Sacred Heart Parish, Sydney, NS

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