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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000036

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Louis SimonCohen Sex Male

Date of Birth November 21, 1924 Place of Birth Whitney PierCounty of Cape Breton

Name of Father David Cohen MAIDEN NAME of Mother Fanny Jankielowitz

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

Residence of Father when child was born Whitney Pier Present address of Father 602 George St. Sydney, Cape Breton Co., NS

Occupation of Father at Birth of child Grocher Place of birth of Father Timkowitz, Russia

Race Name and present address of Physician in attendance at birth

Signature of Applicant David Cohen Address of Applicant 602 George St., Sydney, Cape Breton Co., NS Date August 23, 1947

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Louis SimonCohen

Born at Whitney Pier in the County of Cape Breton

That Louis SimonCohen Whose Birth is sought to be registered was

born at Whitney Pier Cape Breton County on November 21, 1924

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

That I was present in the house where he was born and when he was born.

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