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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000643

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary ChristinaMalcolm Sex Female

Date of Birth December 5, 1924 Place of Birth Port HawkesburyCounty of Inverness

Name of Father Henry Herbert Malcolm MAIDEN NAME of Mother Sabine Rose Forgeron

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 Fisherman Place of birth of Father Port Hawkesbury, Inverness Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Elizabeth Rose White Address of Applicant 262 Traynor Avenue, Kitchener, Ontario Date 31 July 1979

Relationship of Applicant to child Sister

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary ChristinaMalcolm

Born at Port Hawkesbury in the County of Inverness

That Mary ChristinaMalcolm Whose Birth is sought to be registered was

born at Port Hawkesbury Inverness County on December 5, 1924

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

Baptismal Certificate

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