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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100178

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary JohannaBurke Sex Female

Date of Birth December 7, 1920 Place of Birth Glace BayCounty of Cape Breton

Name of Father James Henry Burke MAIDEN NAME of Mother  Boudreau

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

Residence of Father when child was born Glace Bay Present address of Father deceased

Occupation of Father at Birth of child Miner Place of birth of Father Morien

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mary Johanna Burke Fraser Address of Applicant Glace Bay Date August 3, 1982

Relationship of Applicant to child Myself

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary JohannaBurke

Born at Glace Bay in the County of Cape Breton

That Mary JohannaBurke Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on December 7, 1920

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

Certificate of Baptism

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