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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91700015

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth January 6, 1922 Place of Birth New Aberdeen, Glace BayCounty of Cape Breton

Name of Father Michael Moseychuck MAIDEN NAME of Mother Stella Pastek

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

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Stella Moseychuck Address of Applicant New Waterford, Cape Breton Co., NS Date 2 October 1942

Relationship of Applicant to child Mother

AFFIDAVIT

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

Born at New Aberdeen, Glace Bay in the County of Cape Breton

That StephenMoseychuck Whose Birth is sought to be registered was

born at New Aberdeen, Glace Bay Cape Breton County on January 6, 1922

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

I am the mother of the child Stephen and I distinctly remember the date of the birth of my child.

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