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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000885

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth December 2, 1922 Place of Birth SydneyCounty of Cape Breton

Name of Father Antoni Melski MAIDEN NAME of Mother Mary Piscouk

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

Residence of Father when child was born 76 Ferris Street, Sydney, Cape Breton Present address of Father Deceased

Occupation of Father at Birth of child Steel worker Place of birth of Father Grodek, Poland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Joseph Melski Address of Applicant 30 Mechanic Street, Sydney, Cape Breton Date 4 March 1982

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That JosephMelski Whose Birth is sought to be registered was

born at Sydney Cape Breton County on December 2, 1922

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

Certificate of baptism

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