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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200225

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Cyril AustinKaizer Sex Male

Date of Birth November 10, 1919 Place of Birth HalifaxCounty of Halifax

Name of Father Reginald Austin Kaizer MAIDEN NAME of Mother Agusta Agnes Kaizer

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

Residence of Father when child was born Halifax Present address of Father 124 Cunard St.

Occupation of Father at Birth of child Carpenter Place of birth of Father Halifax

Race Name and present address of Physician in attendance at birth Dr. George A. Macintosh

Signature of Applicant Reginald Austin Kaizer Address of Applicant 124 Cunard St. Date 18 November 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Cyril AustinKaizer

Born at Halifax in the County of Halifax

That Cyril AustinKaizer Whose Birth is sought to be registered was

born at Halifax Halifax County on November 10, 1919

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

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