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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000744

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Catherine AnnieRudzevicius Sex Female

Date of Birth July 9, 1922 Place of Birth Sydney MinesCounty of Cape Breton

Name of Father John Rudzevicius MAIDEN NAME of Mother Eva Macziokiuti

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

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

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Catherine Coakley Address of Applicant 6 Pond Road, Sydney Mines, Cape Breton Date 12 April 1979

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Catherine AnnieRudzevicius

Born at Sydney Mines in the County of Cape Breton

That Catherine AnnieRudzevicius Whose Birth is sought to be registered was

born at Sydney Mines Cape Breton County on July 9, 1922

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

Baptismal

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