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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000324

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Leo JuissippiCasavechia Sex Male

Date of Birth July 6, 1921 Place of Birth WoodsideCounty of Halifax

Name of Father Rudolfe Casavechia MAIDEN NAME of Mother Guipippa Lavatoria

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

Residence of Father when child was born Woodside Present address of Father Vancouver

Occupation of Father at Birth of child Bricklayer Place of birth of Father Italy

Race Italian Name and present address of Physician in attendance at birth Dr. Burns

Signature of Applicant Leo Juissippi Casavechia Address of Applicant 12 Mountbatten Ave. Dartmouth Date January 13, 1964

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Leo JuissippiCasavechia

Born at Woodside in the County of Halifax

That Leo JuissippiCasavechia Whose Birth is sought to be registered was

born at Woodside Halifax County on July 6, 1921

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

Baptism Record

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