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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100020

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Vanda Micholsky Sex Female

Date of Birth August 17, 1920 Place of Birth New WaterfordCounty of Cape Breton

Name of Father John Micholsky MAIDEN NAME of Mother Catherine Pichenloka

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

Residence of Father when child was born New Waterford Present address of Father dead

Occupation of Father at Birth of child Coal miner Place of birth of Father Warsaw, Poland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Vanda Moreski Address of Applicant St. Catherine's, Ontario Date August 23, 1979

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Vanda Micholsky

Born at New Waterford in the County of Cape Breton

That Vanda Micholsky Whose Birth is sought to be registered was

born at New Waterford Cape Breton County on August 17, 1920

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

I am Vanda Micholska - having married and become Vanda Moreski

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