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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100140

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Russell Joseph LeviDort Sex Male

Date of Birth April 24, 1922 Place of Birth Halfway CoveCounty of Guysborough

Name of Father Joseph Henry Dort MAIDEN NAME of Mother Nellie George

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

Residence of Father when child was born Halfway Cove, Guysborough Present address of Father

Occupation of Father at Birth of child Place of birth of Father Halfway Cove, Guysborough

Race Name and present address of Physician in attendance at birth

Signature of Applicant Russell Dort Address of Applicant RR #3, Westville, Pictou Date 14 June 1996

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Russell Joseph LeviDort

Born at Halfway Cove in the County of Guysborough

That Russell Joseph LeviDort Whose Birth is sought to be registered was

born at Halfway Cove Guysborough County on April 24, 1922

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

Baptismal certificate; information from late mother.

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