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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000480

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth January 7, 1921 Place of Birth SydneyCounty of Cape Breton

Name of Father John Skrypnick MAIDEN NAME of Mother Catherine Mykita

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 Place of birth of Father

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

Signature of Applicant E. Nardacchio Address of Applicant 5860 Hillside Ave. Sydney Date November 23, 1971

Relationship of Applicant to child Brother in law

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That WilliamSkrypnick Whose Birth is sought to be registered was

born at Sydney Cape Breton County on January 7, 1921

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

Baptism Certificate

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