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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000500

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth April 1, 1920 Place of Birth SydneyCounty of Cape Breton

Name of Father John Melnyk MAIDEN NAME of Mother Mary Klymkovich

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

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

Occupation of Father at Birth of child Steelworker Place of birth of Father Ukraine (Poland)

Race Ukranian Name and present address of Physician in attendance at birth Midwife

Signature of Applicant Sophie Melnyk Banfield Address of Applicant Louisburg Date October 2, 1969

Relationship of Applicant to child self

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That SophieMelnyk Whose Birth is sought to be registered was

born at Sydney Cape Breton County on April 1, 1920

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

Certificate of Baptism & Information received from parents

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