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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000417

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Donald BernardMacDougall Sex Male

Date of Birth April 7, 1924 Place of Birth Port HawkesburyCounty of Inverness

Name of Father Hugh A. MacDougall MAIDEN NAME of Mother Mary Catehrine MacDougall

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

Residence of Father when child was born Port Hawkesbury, Inverness Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Labourer Place of birth of Father Rhodena, Inverness Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Donald B. MacDougall Address of Applicant Port Hawkesbury, Inverness Co., NS Date 14 February 1974

Relationship of Applicant to child Same person

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Donald BernardMacDougall

Born at Port Hawkesbury in the County of Inverness

That Donald BernardMacDougall Whose Birth is sought to be registered was

born at Port Hawkesbury Inverness County on April 7, 1924

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

Certificate of birth and baptism from St. Joseph's Parish, Port Hawkesbury, Inverness Co., NS

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