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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000202

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Bertha KateKeller Sex Female

Date of Birth November 8, 1921 Place of Birth SydneyCounty of Cape Breton

Name of Father Joseph Keller MAIDEN NAME of Mother Mary  Cziperle

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 Store Keeper Place of birth of Father Hungary

Race Hungarian Name and present address of Physician in attendance at birth

Signature of Applicant Joseph Keller Address of Applicant 44 Lingan Road. Sydney Date April 25, 1955

Relationship of Applicant to child Brother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Bertha KateKeller

Born at Sydney in the County of Cape Breton

That Bertha KateKeller Whose Birth is sought to be registered was

born at Sydney Cape Breton County on November 8, 1921

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

On Certificate of baptism Holy Redeemer Church, Sydney, NS

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