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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000644

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Rita PenelopeMacGillivray Sex Female

Date of Birth June 11, 1924 Place of Birth Malignant CoveCounty of Antigonish

Name of Father Hugh MacGillivray MAIDEN NAME of Mother Catherine MacInnis

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

Residence of Father when child was born Malignant Cove, Antigonish Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Fisherman Place of birth of Father Malignant Cove, Antigonish Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Guy O. Mattatall Address of Applicant 1762 Temperance Street, PO Box 186, Westville, Pictou Co., NS Date 5 May 1979

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Rita PenelopeMacGillivray

Born at Malignant Cove in the County of Antigonish

That Rita PenelopeMacGillivray Whose Birth is sought to be registered was

born at Malignant Cove Antigonish County on June 11, 1924

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

See enclosed Baptism ceertificate

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