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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100159

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth March 22, 1920 Place of Birth SydneyCounty of Cape Breton

Name of Father John Kozera MAIDEN NAME of Mother Johanna Blogostowski

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 Warsaw, Poland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Winnifred Thenerkauf Address of Applicant Sydney Date January 26, 1981

Relationship of Applicant to child

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That WandaKozera Whose Birth is sought to be registered was

born at Sydney Cape Breton County on March 22, 1920

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

I lived next door (5) Ferris St. at the time of her birth. Her mother was my god-mother. - Walter Bluzey

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