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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000369

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth April 9, 1922 Place of Birth SydneyCounty of Cape Breton

Name of Father eli Hirsch MAIDEN NAME of Mother Ida Shlosberg

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

Residence of Father when child was born 168 Laurier Street, Sydney, Cape Breton Present address of Father Sydney, Cape Breton

Occupation of Father at Birth of child Grocer Place of birth of Father Poland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Minnie Hirsch Address of Applicant 184 Park Street, Sydney, Cape Breton Date 21 March 1969

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That MinnieHirsch Whose Birth is sought to be registered was

born at Sydney Cape Breton County on April 9, 1922

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

I am the father of the said child, who is also the applicant.

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