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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000419

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Boris EvanVarbeff Sex Male

Date of Birth July 23, 1922 Place of Birth QueenslandCounty of Halifax

Name of Father William Varbeff MAIDEN NAME of Mother mary Peters

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Queensland, Halifax Present address of Father 4 Daye Avenue, Dartmouth

Occupation of Father at Birth of child Clerk Place of birth of Father Bulgaria

Race Name and present address of Physician in attendance at birth

Signature of Applicant Boris E. Varbeff Address of Applicant 36 Elmwood Avenue Date 19 July 1971

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Boris EvanVarbeff

Born at Queensland in the County of Halifax

That Boris EvanVarbeff Whose Birth is sought to be registered was

born at Queensland Halifax County on July 23, 1922

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

Parents marriage shows surname Varbeff

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