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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000525

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth February 22, 1923 Place of Birth BridgewaterCounty of Lunenburg

Name of Father Percy Himmelman MAIDEN NAME of Mother Phoebe Lohnes

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

Residence of Father when child was born Bridgewater Present address of Father Bridgewater

Occupation of Father at Birth of child Carpenter Place of birth of Father Bridgewater

Race Name and present address of Physician in attendance at birth

Signature of Applicant Bernard Himmelman Address of Applicant 1617 King St. Bridgewater Date June 26, 1975

Relationship of Applicant to child same person

AFFIDAVIT

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

Born at Bridgewater in the County of Lunenburg

That Bernard JamesHimmelman Whose Birth is sought to be registered was

born at Bridgewater Lunenburg County on February 22, 1923

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

As per Baptismal Certificate enclosed

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