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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90600922

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of MaryPlousakis Sex Female

Date of Birth July 3, 1921 Place of Birth New GlasgowCounty of Pictou

Name of Father Apostolos John Plousakis MAIDEN NAME of Mother Xanthiopi Markos

Residence of Father when child was born New Glasgow, Pictou Co., NS Present address of Father 1452 St. Dominique, Montreal, Quebec

Occupation of Father at Birth of child Restaurant Owner Place of birth of Father Crete, Greece

Race Name and present address of Physician in attendance at birth

Signature of Applicant Apostolos J. Plousakis Address of Applicant 1452 St. Dominique, Montreal, Quebec Date 4 May 1939

Relationship of Applicant to child Father

AFFIDAVIT

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

Born at New Glasgow in the County of Pictou

That MaryPlousakis Whose Birth is sought to be registered was

born at New Glasgow Pictou County on July 3, 1921

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

I am the father of the child

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