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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90600299

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Joseph W.Nitsch Sex Male

Date of Birth August 13, 1921 Place of Birth Glace BayCounty of Cape Breton

Name of Father Edward J. Nitsch MAIDEN NAME of Mother Pauline Shenkovsky

Residence of Father when child was born Glace Bay, New Aberdeen, Cape Breton Co., NS Present address of Father Yonkers, New York, USA

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Pauline Nitsch Address of Applicant Yonkers, New York, USA Date 29 November 1933

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Joseph W.Nitsch

Born at Glace Bay in the County of Cape Breton

That Joseph W.Nitsch Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on August 13, 1921

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

I am the boys grandmother and visited my daughter in St. Joseph's Hospital, where the child was born.

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