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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

64500240

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth December 31, 1919 Place of Birth SpringhillCounty of Cumberland

Name of Father Gustav Shubert MAIDEN NAME of Mother Luedine Feishmen

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

Residence of Father when child was born Springhill Present address of Father

Occupation of Father at Birth of child Miner Place of birth of Father Rudolstadt, Germany

Race Name and present address of Physician in attendance at birth Mrs. Elsie Halversen

Signature of Applicant Gustav Shubert Address of Applicant Springhill Date 20 January 1920

Relationship of Applicant to child father

AFFIDAVIT

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

Born at Springhill in the County of Cumberland

That ErnaShubert Whose Birth is sought to be registered was

born at Springhill Cumberland County on December 31, 1919

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

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