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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90501431

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Lily MicheleHirsch Sex Female

Date of Birth August 31, 1920 Place of Birth SydneyCounty of Cape Breton

Name of Father Joseph Hirsch MAIDEN NAME of Mother Bella Dubinsky

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

Residence of Father when child was born 87 Hankard Street, Sydney Present address of Father 87 Hankard Street, Sydney

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

Race Hebrew Name and present address of Physician in attendance at birth Dr. Roy, 308 George Street, Sydney

Signature of Applicant Bella Hirsch Address of Applicant 87 Hankard Street, Sydney Date 28 October 1940

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Lily MicheleHirsch

Born at Sydney in the County of Cape Breton

That Lily MicheleHirsch Whose Birth is sought to be registered was

born at Sydney Cape Breton County on August 31, 1920

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

I am her mother and I know the facts as stated above are correct and true

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