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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000606

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Carl MurryLerch Sex Male

Date of Birth December 21, 1924 Place of Birth HalifaxCounty of Halifax

Name of Father Frank Joseph Lerch MAIDEN NAME of Mother Olive Boutilier

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

Residence of Father when child was born Dartmouth, NS Present address of Father Deceased

Occupation of Father at Birth of child Mechanic Place of birth of Father Czechoslovakia

Race Name and present address of Physician in attendance at birth

Signature of Applicant Carl M. Lerch Address of Applicant 26 Esdaile Avenue, Dartmouth, NS Date 29 January 1979

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Carl MurryLerch

Born at Halifax in the County of Halifax

That Carl MurryLerch Whose Birth is sought to be registered was

born at Halifax Halifax County on December 21, 1924

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

Baptism & Marriage

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