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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000035

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of SidneyChernin Sex Male

Date of Birth December 12, 1923 Place of Birth Glace BayCounty of Cape Breton

Name of Father William Chernin MAIDEN NAME of Mother Minnie Godinsky

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

Residence of Father when child was born Minto Street Glace Bay Cape Breton Co. Ns Present address of Father 1 Prince Street, 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 William Chernin Address of Applicant 1 Prince Street, Glace Bay, Cape Breton Co., NS Date 23 April 1947

Relationship of Applicant to child Father

AFFIDAVIT

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

Born at Glace Bay in the County of Cape Breton

That SidneyChernin Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on December 12, 1923

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

I am the father of the child and I was present at his birth.

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