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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000561

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth April 25, 1920 Place of Birth Glace BayCounty of Cape Breton

Name of Father Max Shore MAIDEN NAME of Mother Sable Schneiderman

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

Residence of Father when child was born Glace Bay Present address of Father deceased

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

Race Hebrew Name and present address of Physician in attendance at birth Dr. Green (Deceased)

Signature of Applicant Archie Shore Address of Applicant 18 Catherine Street (Glace Bay) Date July 21, 1971

Relationship of Applicant to child Self

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 25, 1920

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

It is the age shown on an Extract from Hospital Records, Glace Bay General Hospital, Glace Bay which has already been submitted to Registrar General Office at Halifax. It is also the date shown on the certified extract from the Family Bible of the parents of the Applicant, which is attached herewith. Marriage solemnized at New Waterford, August 29, 1946 acco(r)ding to Hebrew Rite.

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