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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90701014

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of ArchieShore Sex Male

Date of Birth April 24, 1920 Place of Birth Glace BayCounty of Cape Breton

Name of Father Max Shore MAIDEN NAME of Mother Sable Schneidermann

Residence of Father when child was born 3 Ingraham's Lane, Glace Bay Present address of Father 3 Ingraham's Lane, Glace Bay

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

Race White Name and present address of Physician in attendance at birth Dr. F. G. MacAskill, Yorke St., Glace Bay

Signature of Applicant Max Shore Address of Applicant 3 Ingraham's Lane, Glace Bay Date 5 August 1937

Relationship of Applicant to child Father

AFFIDAVIT

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

Born at Glace Bay in the County of Cape Breton

That ArchieShore Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on April 24, 1920

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

I am the father of the said Archie Shore. His birth is recorded in my family bible in connection with the Jewish Religious Ceremony Attendant upon the birth of a male child

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