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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000739

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Floyd WesleyMacLeod Sex Male

Date of Birth November 28, 1924 Place of Birth DonkinCounty of Cape Breton

Name of Father John Angus MacLeod MAIDEN NAME of Mother Robina Boutilier

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

Residence of Father when child was born Dominion No. 6, (Donkin), Cape Breton Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Coal Miner Place of birth of Father Glace Bay, Cape Breton Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Elizabeth MacLeod Address of Applicant 38 Grove Street, Glace Bay, Cape Breton Co., NS Date 1 September 1982

Relationship of Applicant to child Wife

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Floyd WesleyMacLeod

Born at Donkin in the County of Cape Breton

That Floyd WesleyMacLeod Whose Birth is sought to be registered was

born at Donkin Cape Breton County on November 28, 1924

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

Baptism Certificate (enclosed)

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