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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100365

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

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

Name of Father Paul Passnick MAIDEN NAME of Mother Helen (Tikena) Ducmuk

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 Coal Miner Place of birth of Father Ukraine

Race Name and present address of Physician in attendance at birth

Signature of Applicant Anthony Passnick Address of Applicant Toronto Date October 29, 1984

Relationship of Applicant to child self

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That AnthonyPassnick Whose Birth is sought to be registered was

born at Sydney Cape Breton County on March 1, 1920

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

Documentation held by D.F. Arthur, Deputy Registrar General Department of Health, P.O. Box 157, Halifax, B3J 2H9 (see attached)

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