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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000797

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Wilfred DenisBurke Sex Male

Date of Birth April 26, 1921 Place of Birth MinudieCounty of Cumberland

Name of Father Simon Burke MAIDEN NAME of Mother Helen Robins

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

Residence of Father when child was born Barrensfield Present address of Father deceased

Occupation of Father at Birth of child Farm worker for Clarence Pugsley Place of birth of Father Minudie

Race Name and present address of Physician in attendance at birth

Signature of Applicant Wilfred Denis Burke Address of Applicant 127 Gray St. Sydney Date February 26, 1979

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Wilfred DenisBurke

Born at Minudie in the County of Cumberland

That Wilfred DenisBurke Whose Birth is sought to be registered was

born at Minudie Cumberland County on April 26, 1921

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

See Certificate of Birth attached

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