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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000066

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

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

Name of Father Louis Gaum MAIDEN NAME of Mother Pearl Moroff

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

Residence of Father when child was born Sydney Cape Breton Co. Ns Present address of Father 816 Victoria Road, Sydney, Cape Breton Co., NS

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Pearl Gaum Address of Applicant 816 Victoria Road, Sydney, Cape Breton Co., NS Date 15 April 1948

Relationship of Applicant to child Mother

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That CyrilGaum Whose Birth is sought to be registered was

born at Sydney Cape Breton County on January 13, 1923

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

I am Cyril Gaum's mother and well recall the date of his birth.

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