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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

92800694

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth May 4, 1920 Place of Birth SydneyCounty of Cape Breton

Name of Father Cornelius Zagwolski MAIDEN NAME of Mother Annie Fedesyn

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

Residence of Father when child was born Sydney, Cape Breton Co. Present address of Father deceased

Occupation of Father at Birth of child Steelworker Place of birth of Father Austria

Race White Name and present address of Physician in attendance at birth Dr. McRae

Signature of Applicant Mrs. Annie Zagwolski Address of Applicant 14 Ferris Street, Sydney Date 15 July 1944

Relationship of Applicant to child Mother

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That MaryZagwolski Whose Birth is sought to be registered was

born at Sydney Cape Breton County on May 4, 1920

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

That I am the said child's mother

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