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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000699

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Thomas EdwardBurke Sex Male

Date of Birth June 9, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father David Burke MAIDEN NAME of Mother Mary MacKinnon

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 Coal Miner Place of birth of Father Port Morien, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant Thomas Edward Burke Address of Applicant PO Box 146, Glace Bay, Cape Breton Date 10 July 1978

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Thomas EdwardBurke

Born at Glace Bay in the County of Cape Breton

That Thomas EdwardBurke Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on June 9, 1922

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

I am the oldest living sister of Thomas Edward Burke, being eight years his senior, and the facts in the above application concerning the parentage and birth of my brother Thomas Edward Burke are true to the best of my knowledge and belief

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