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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000203

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Ivan DaleMcCormack Sex Male

Date of Birth September 5, 1924 Place of Birth New EdinburghCounty of Digby

Name of Father Harry McCormack MAIDEN NAME of Mother Florence Deveau

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

Residence of Father when child was born New Edinburgh, Digby Co., NS Present address of Father New Edinburgh, Digby Co., NS

Occupation of Father at Birth of child Labourer Place of birth of Father New Edinburgh, Digby Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Ivan Dale McCormack Address of Applicant 7 Laurier Drive, Oromocto, New Brunswick Date 22 April 1958

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Ivan DaleMcCormack

Born at New Edinburgh in the County of Digby

That Ivan DaleMcCormack Whose Birth is sought to be registered was

born at New Edinburgh Digby County on September 5, 1924

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

His mother (family bible record & school record)

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