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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90501510

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of MarianMorykot Sex Female

Date of Birth September 12, 1920 Place of Birth SydneyCounty of Cape Breton

Name of Father Michael Morykot MAIDEN NAME of Mother Anna Zagwolski

Residence of Father when child was born 69 Langan Road, Sydney Present address of Father deceased

Occupation of Father at Birth of child Worker in Steel Mill Place of birth of Father Poland

Race Polish Caucasion Name and present address of Physician in attendance at birth Midwife, Mrs. Bereciena, Henry Street, Sydney

Signature of Applicant Anthony Lucas Address of Applicant 19363 Hull Avenue, Detroit, Michigan, USA Date 12 April 1940

Relationship of Applicant to child Brother

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That MarianMorykot Whose Birth is sought to be registered was

born at Sydney Cape Breton County on September 12, 1920

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

Marian Morykot's mother is my mother bur her father married my mother after my father's death. I was at home at the time of Marian Morykot's birth. I was fifteen years of age.

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