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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90600406

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Elizabeth MarieAlthoff Sex Female

Date of Birth May 25, 1921 Place of Birth Little Bras d'OrCounty of Cape Breton

Name of Father Karl Althoff MAIDEN NAME of Mother Christine Schubert

Residence of Father when child was born Little Bras d'Or, Cape Breton Co., NS Present address of Father Passchendaele, Cape Breton Co., NS

Occupation of Father at Birth of child Miner Place of birth of Father Passchendaele, Cape Breton Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Karl Althoff Address of Applicant Passchendaele, Cape Breton Co., NS Date 12 January 1934

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Elizabeth MarieAlthoff

Born at Little Bras d'Or in the County of Cape Breton

That Elizabeth MarieAlthoff Whose Birth is sought to be registered was

born at Little Bras d'Or Cape Breton County on May 25, 1921

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

I am her father and was present at the time of birth.

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