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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000972

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Assad WalterJabalee Sex Male

Date of Birth July 9, 1922 Place of Birth Sydney MinesCounty of Cape Breton

Name of Father George Jabalee MAIDEN NAME of Mother Sadie Balah

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

Residence of Father when child was born Sydney Mines, Cape Breton Present address of Father Deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Zahli, Lebanon

Race Name and present address of Physician in attendance at birth

Signature of Applicant Assad Walter Jabalee Address of Applicant 42077 Toddmark Lane, Mt. Clemens, Michigan, 48044, USA Date 6 March 1984

Relationship of Applicant to child Same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Assad WalterJabalee

Born at Sydney Mines in the County of Cape Breton

That Assad WalterJabalee Whose Birth is sought to be registered was

born at Sydney Mines Cape Breton County on July 9, 1922

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

Knowledge of applicant and family for 35 years. Baptismal certificate stating such facts. Herein enclosed.

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