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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000761

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of SelinaHaddad Sex Female

Date of Birth July 20, 1920 Place of Birth SydneyCounty of Cape Breton

Name of Father Joseph Haddad MAIDEN NAME of Mother Rufina Libbus

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

Residence of Father when child was born Sydney Present address of Father deceased

Occupation of Father at Birth of child Shoe shine shop Place of birth of Father Lebanon

Race Lebanese Name and present address of Physician in attendance at birth Dr. J.G.B. Lynch, deceased

Signature of Applicant Selina Haddad Hollohan Address of Applicant Sydney Date January 23, 1976

Relationship of Applicant to child self

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That SelinaHaddad Whose Birth is sought to be registered was

born at Sydney Cape Breton County on July 20, 1920

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

Certificate of Birth and Baptism (attached hereto)

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