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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100100

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of JohnParuch Sex Male

Date of Birth December 19, 1920 Place of Birth SydneyCounty of Cape Breton

Name of Father Michael Paruch MAIDEN NAME of Mother Frances Adamus

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 Poland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Edward P. Paruch Address of Applicant 28 Cornishtown Road, Sydney Date 18 December 1980

Relationship of Applicant to child Fist cousin

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That JohnParuch Whose Birth is sought to be registered was

born at Sydney Cape Breton County on December 19, 1920

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

Church records - attendance at school for 12 years. Known the person for a lifetime.

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