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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000491

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of HenriettaMacAulay Sex Female

Date of Birth June 25, 1924 Place of Birth SydneyCounty of Cape Breton

Name of Father   MAIDEN NAME of Mother Hattie MacAulay

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Present address of Father

Occupation of Father at Birth of child Place of birth of Father

Race Name and present address of Physician in attendance at birth

Signature of Applicant Sister Ellen Grant, RSW Address of Applicant 69 Kings Road, Sydney, Cape Breton Co., NS Date 28 January 1976

Relationship of Applicant to child None

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That HenriettaMacAulay Whose Birth is sought to be registered was

born at Sydney Cape Breton County on June 25, 1924

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

Record of admission of above to St. Mary's Home, Sydney on June 25, 1924

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