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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90600310

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth October 13, 1922 Place of Birth SydneyCounty of Cape Breton

Name of Father Abraheem J. Gallay MAIDEN NAME of Mother Bella Ketz

Residence of Father when child was born West Street, Sydney, Cape Breton Co., NS Present address of Father Yorke Street, Glace Bay, Cape Breton Co., NS

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant A. J. Gallay Address of Applicant 17 Yorke Street, Glace Bay, Cape Breton Co., NS Date 26 February 1934

Relationship of Applicant to child Father

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That PearlGallay Whose Birth is sought to be registered was

born at Sydney Cape Breton County on October 13, 1922

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

I am her father

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