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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000556

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Helen ElizabethPhillips Sex Female

Date of Birth July 19, 1922 Place of Birth Gardiner MinesCounty of Cape Breton

Name of Father Stephen Phillips MAIDEN NAME of Mother Magdalen Menchuk

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

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

Occupation of Father at Birth of child Coal Miner Place of birth of Father Austria

Race Name and present address of Physician in attendance at birth

Signature of Applicant Helen Elizabeth Musial Address of Applicant Gardiner Mines, Cape Breton Date 11 October 1975

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Helen ElizabethPhillips

Born at Gardiner Mines in the County of Cape Breton

That Helen ElizabethPhillips Whose Birth is sought to be registered was

born at Gardiner Mines Cape Breton County on July 19, 1922

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

Certification from parish records, Immaculate Conception Parish, Glace Bay. Personal knowledge passed on to me from my parents.

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