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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000604

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

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

Name of Father Gregory Harry Tataryn MAIDEN NAME of Mother Maria Markiw

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

Residence of Father when child was born Sydney Present address of Father 299 Lingan Rd. Sydney

Occupation of Father at Birth of child Retired Place of birth of Father Ukraine

Race Name and present address of Physician in attendance at birth

Signature of Applicant Michael Tataryn Address of Applicant 299 Lingan Rd. Sydney Date December 29, 1975

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That MichaelTataryn Whose Birth is sought to be registered was

born at Sydney Cape Breton County on June 1, 1921

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

This is my own birth

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