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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000328

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Roy WilliamSteplock Sex Male

Date of Birth June 22, 1921 Place of Birth SydneyCounty of Cape Breton

Name of Father Vincent Steplock MAIDEN NAME of Mother Lillian Lewis

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

Residence of Father when child was born 116 Laurier St. Sydney Present address of Father 247 Province St. Hamilton, Ontario

Occupation of Father at Birth of child Nail Operator Place of birth of Father Bessarbia, Russia

Race Ukrainian Name and present address of Physician in attendance at birth Dr. Lynch

Signature of Applicant Lillian Steplock Address of Applicant 288 Catherine St. Hamilton, Ontario Date 5 February 1964

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Roy WilliamSteplock

Born at Sydney in the County of Cape Breton

That Roy WilliamSteplock Whose Birth is sought to be registered was

born at Sydney Cape Breton County on June 22, 1921

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

I am his mother

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