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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000364

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth July 25, 1924 Place of Birth New HarrisCounty of Victoria

Name of Father George A. MacKenzie MAIDEN NAME of Mother Agnes Carmichael

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 Deceased

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Nelson MacKenzie Address of Applicant 515 William Avenue, Winnipeg, Manitoba Date 2 February 1972

Relationship of Applicant to child Person concerned

AFFIDAVIT

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

Born at New Harris in the County of Victoria

That NelsonMacKenzie Whose Birth is sought to be registered was

born at New Harris Victoria County on July 25, 1924

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

Family register 1931 census report 1940 National Registration record

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