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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000490

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of John MalcolmMacInnis Sex Male

Date of Birth June 6, 1924 Place of Birth Port HawkesburyCounty of Inverness

Name of Father Allan MacInnis MAIDEN NAME of Mother Sarah MacDonald

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 Port Hawkesbury, Inverness Co., NS

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Frances Cullen Address of Applicant 6224 Leeds Street, Halifax, NS Date 10 February 1976

Relationship of Applicant to child Friend

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of John MalcolmMacInnis

Born at Port Hawkesbury in the County of Inverness

That John MalcolmMacInnis Whose Birth is sought to be registered was

born at Port Hawkesbury Inverness County on June 6, 1924

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

Baptismal record

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