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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91900673

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Yetta HelenGlick Sex Female

Date of Birth July 10, 1921 Place of Birth HalifaxCounty of Halifax

Name of Father John Glick MAIDEN NAME of Mother Jenny Glick

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

Residence of Father when child was born Halifax, NS Present address of Father Halifax, NS

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant John Glick Address of Applicant Halifax, NS Date 11 September 1945

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Yetta HelenGlick

Born at Halifax in the County of Halifax

That Yetta HelenGlick Whose Birth is sought to be registered was

born at Halifax Halifax County on July 10, 1921

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

That I am the father of Yetta Helen Glick

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