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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000570

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

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

Name of Father Thomas Kawecki MAIDEN NAME of Mother Jeanie Tetanish

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 Taylor Place of birth of Father Ukraine

Race Name and present address of Physician in attendance at birth

Signature of Applicant Bill Kawecki Address of Applicant Edwardsville Date October 2, 1974

Relationship of Applicant to child Wife (Mrs. Roberta Kawecki)

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That BillKawecki Whose Birth is sought to be registered was

born at Sydney Cape Breton County on February 8, 1921

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

William Baptismal Certificate

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