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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000326

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of George GordonBorgal Sex Male

Date of Birth January 4, 1921 Place of Birth Pleasant HarbourCounty of Halifax

Name of Father Louis Borgal MAIDEN NAME of Mother Hazel May Jennings

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

Residence of Father when child was born Pleasant Harbour Present address of Father Birch St. Fairview

Occupation of Father at Birth of child Fisherman Place of birth of Father Pleasant Harbour

Race Dutch Name and present address of Physician in attendance at birth

Signature of Applicant George Gordon Borgal Address of Applicant 6920 Vaughan Ave. Halifax Date 5 February 1964

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of George GordonBorgal

Born at Pleasant Harbour in the County of Halifax

That George GordonBorgal Whose Birth is sought to be registered was

born at Pleasant Harbour Halifax County on January 4, 1921

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

Information received parents and Baptism Certificate and Marriage record

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