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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000033

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth May 6, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father John Kazamel MAIDEN NAME of Mother Agnes Mollish

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

Residence of Father when child was born Douglas Avenue, Glace Bay, Cape Breton Present address of Father 123 Douglas Avenue, Glace Bay, Cape Breton

Occupation of Father at Birth of child Miner Place of birth of Father Poland

Race Name and present address of Physician in attendance at birth

Signature of Applicant John Kazamel Address of Applicant 123 Douglas Avenue, Glace Bay, Cape Breton Date 21 May 1947

Relationship of Applicant to child Father

AFFIDAVIT

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

Born at Glace Bay in the County of Cape Breton

That EdwardKazamel Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on May 6, 1922

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

Because I am the father of the said Edward Kazamel and was present in the home on the date of the birth and can clearly recall the date of birth

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