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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

92000892

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Carrol SylviaLipton Sex Female

Date of Birth May 13, 1923 Place of Birth SydneyCounty of Cape Breton

Name of Father Nathan Lipton MAIDEN NAME of Mother Lena Green

Residence of Father when child was born Sydney, Cape Breton Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Hotel Proprietor Place of birth of Father Russia

Race Name and present address of Physician in attendance at birth

Signature of Applicant Lena Lipton Address of Applicant Halifax, NS Date 19 February 1942

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Carrol SylviaLipton

Born at Sydney in the County of Cape Breton

That Carrol SylviaLipton Whose Birth is sought to be registered was

born at Sydney Cape Breton County on May 13, 1923

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

I am her mother

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