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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

92800318

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth August 1, 1921 Place of Birth Glace BayCounty of Cape Breton

Name of Father Bernard Lipkus MAIDEN NAME of Mother Fanny Hoffman

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

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Fanny Lipkus Address of Applicant 150 Brookside Street, Glace Bay, Cape Breton Co., NS Date 27 October 1944

Relationship of Applicant to child Mother

AFFIDAVIT

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

Born at Glace Bay in the County of Cape Breton

That LillianLipkus Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on August 1, 1921

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

I am her mother

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