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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000533

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth April 15, 1921 Place of Birth SydneyCounty of Cape Breton

Name of Father Alex Chezenko MAIDEN NAME of Mother Genevieve Filck

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 Poland

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

Signature of Applicant Mrs. Genevieve Fougere Address of Applicant 732 Westmount Rd. Sydney Date November 8, 1973

Relationship of Applicant to child Mohter

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That FrankChezenko Whose Birth is sought to be registered was

born at Sydney Cape Breton County on April 15, 1921

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

Baptismal record and marriage record extract re Parents.

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