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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000110

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth June 11, 1924 Place of Birth New HarrisCounty of Victoria

Name of Father Kenneth Angus MacKenzie MAIDEN NAME of Mother Margaret Francis Gunn

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

Residence of Father when child was born New Harris, Victoria Co., NS Present address of Father New Harris, Victoria Co., NS

Occupation of Father at Birth of child Farmer Place of birth of Father New Harris, Victoria Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Kenneth Angus MacKenzie Address of Applicant New Harris, Victoria Co., NS Date 4 April 1951

Relationship of Applicant to child Father

AFFIDAVIT

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

Born at New Harris in the County of Victoria

That KennethMacKenzie Whose Birth is sought to be registered was

born at New Harris Victoria County on June 11, 1924

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

I am his gather and have his baptismal certificate showing date of birth as June 11th, 1924, hereto annexed

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