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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200013

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Arthur GeorgeSieniewicz Sex Male

Date of Birth October 4, 1919 Place of Birth HalifaxCounty of Halifax

Name of Father Ladislas Sieniewicz MAIDEN NAME of Mother Ludwika Louise Struzynska

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

Residence of Father when child was born Halifax Present address of Father 35 Inglis St.

Occupation of Father at Birth of child Immigrant inspector for the United States Government Place of birth of Father Poland

Race Name and present address of Physician in attendance at birth Dr. J.L. Churchill

Signature of Applicant Ladislas Sieniewicz Address of Applicant 35 Inglis St. Date 03 November 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Arthur GeorgeSieniewicz

Born at Halifax in the County of Halifax

That Arthur GeorgeSieniewicz Whose Birth is sought to be registered was

born at Halifax Halifax County on October 4, 1919

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

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