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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000660

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Frances JuliaMleczko Sex Female

Date of Birth February 16, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father Joseph Mleczko MAIDEN NAME of Mother Mary Witkowski

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

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

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 Frances Lomnicki Address of Applicant 53 Glenview Drive, Stoney Creek, Ontario Date 4 November 1977

Relationship of Applicant to child One and the same person

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Frances JuliaMleczko

Born at Glace Bay in the County of Cape Breton

That Frances JuliaMleczko Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on February 16, 1922

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

I am the elder sister of the applicant and that I was born the 7th day of March, 1918 and I was four years of age at the time of the birth of my sister.

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