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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200312

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Kenneth EdwardKane Sex Male

Date of Birth November 26, 1919 Place of Birth HalifaxCounty of Halifax

Name of Father Timothy Benjamin Kane MAIDEN NAME of Mother Violet Chattenburg

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

Residence of Father when child was born Halifax Present address of Father 105B St John Ave.

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

Race Name and present address of Physician in attendance at birth Dr. V.L. Miller

Signature of Applicant Timothy Kane Address of Applicant Halifax Date 02 December 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Kenneth EdwardKane

Born at Halifax in the County of Halifax

That Kenneth EdwardKane Whose Birth is sought to be registered was

born at Halifax Halifax County on November 26, 1919

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

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