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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000020

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Lauchlin E.MacDougall Sex Male

Date of Birth January 21, 1924 Place of Birth East Lake AinslieCounty of Inverness

Name of Father Dan J. MacDougall MAIDEN NAME of Mother Minnie Margaret MacKay

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

Residence of Father when child was born East Lake Ainslie, Inverness Co., NS Present address of Father East Lake Ainslie, Inverness Co., NS

Occupation of Father at Birth of child Farmer Place of birth of Father East Lake Ainslie, Inverness Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Minnie M. MacDougall Address of Applicant East Lake Ainslie, Inverness Co., NS Date 30 November 1946

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Lauchlin E.MacDougall

Born at East Lake Ainslie in the County of Inverness

That Lauchlin E.MacDougall Whose Birth is sought to be registered was

born at East Lake Ainslie Inverness County on January 21, 1924

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

That I am the mother of said Lauchlin E. MacDougall

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