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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000504

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of AntoninaRylko Sex Female

Date of Birth May 1, 1921 Place of Birth SydneyCounty of Cape Breton

Name of Father John Rylko MAIDEN NAME of Mother Anna Koziolek

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 Steel worker Place of birth of Father Czainec, Biala, Poland

Race Polish Name and present address of Physician in attendance at birth Dr. Rice

Signature of Applicant Antoninia Hunter Address of Applicant 139 Rennie Dr. Kitchener, Ontario Date October 10, 1972

Relationship of Applicant to child n/a

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That AntoninaRylko Whose Birth is sought to be registered was

born at Sydney Cape Breton County on May 1, 1921

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

1) Personal Knowledge 2) Certificate of Baptism

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