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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000044

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Jane EileenMacKenzie Sex Female

Date of Birth September 15, 1924 Place of Birth Glace BayCounty of Cape Breton

Name of Father Charles MacKenzie MAIDEN NAME of Mother Sara Isabel MacDonald

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 Glace Bay, Cape Breton Co., NS

Occupation of Father at Birth of child Clerk Place of birth of Father Gardiner Mines, Cape Breton Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Charles MacKay Address of Applicant Glace Bay, Cape Breton Co., NS Date 9 August 1947

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Jane EileenMacKenzie

Born at Glace Bay in the County of Cape Breton

That Jane EileenMacKenzie Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on September 15, 1924

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

I am the father of Jane Eileen MacKenzie and have personal knowledge of the circumstances of her birth

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