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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

92800308

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Bernard ArthurLeith Sex Male

Date of Birth April 6, 1921 Place of Birth SydneyCounty of Cape Breton

Name of Father Albert Isaac Leith MAIDEN NAME of Mother Mary Gallay

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

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mary Leith Address of Applicant Sydney, Cape Breton Co., NS Date 22 December 1943

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Bernard ArthurLeith

Born at Sydney in the County of Cape Breton

That Bernard ArthurLeith Whose Birth is sought to be registered was

born at Sydney Cape Breton County on April 6, 1921

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

I am the mother of Bernard Arthur Leith

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