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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000335

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth March 26, 1922 Place of Birth SydneyCounty of Cape Breton

Name of Father Joseph Mikoda MAIDEN NAME of Mother Sophia Waleck

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

Residence of Father when child was born Sydney, Cape Breton Present address of Father Deceased

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Joseph Mikoda Address of Applicant 14 Vera Court, Sydney, Cape Breton Date 15 July 1966

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That JosephMikoda Whose Birth is sought to be registered was

born at Sydney Cape Breton County on March 26, 1922

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

Baptism certificate

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