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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000983

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Josepha AnielaKasprovitz Sex Female

Date of Birth January 19, 1921 Place of Birth StellartonCounty of Pictou

Name of Father Peter Kasprovitz MAIDEN NAME of Mother Mary Koziolek

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

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

Occupation of Father at Birth of child Coal miner Place of birth of Father Poland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Josephine Badzioch Address of Applicant 66 Parkwood Dr. Tillsonburg, Ontario Date August 6, 1982

Relationship of Applicant to child Same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Josepha AnielaKasprovitz

Born at Stellarton in the County of Pictou

That Josepha AnielaKasprovitz Whose Birth is sought to be registered was

born at Stellarton Pictou County on January 19, 1921

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

Certificate of Birth and Baptism dated October 8, 1950

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