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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000164

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Andrew JosephMiller Sex Male

Date of Birth May 25, 1920 Place of Birth Sydney MinesCounty of Cape Breton

Name of Father George  Miller MAIDEN NAME of Mother Mary  Brazaitis

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

Residence of Father when child was born Sydney Mines Present address of Father Sydney Mines

Occupation of Father at Birth of child Coal Miner Place of birth of Father Lithuania

Race Lithuanian Name and present address of Physician in attendance at birth Dr. D.W. Archibald, Sydney Mines

Signature of Applicant Mrs. Mary Miller Address of Applicant Pond St. Sydney Mines Date July 5, 1951

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Andrew JosephMiller

Born at Sydney Mines in the County of Cape Breton

That Andrew JosephMiller Whose Birth is sought to be registered was

born at Sydney Mines Cape Breton County on May 25, 1920

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

Registered in Church (Certificate of Baptism attached)

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