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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000034

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of John FrancisBurke Sex Male

Date of Birth February 8, 1923 Place of Birth SydneyCounty of Cape Breton

Name of Father John A. Burke MAIDEN NAME of Mother Terese Cozzolino

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

Residence of Father when child was born Sydney Cape Breton Co. Ns Present address of Father 70 Park Street, Sydney, Cape Breton Co., NS

Occupation of Father at Birth of child Dentist Place of birth of Father St. Jacques, Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Terese Burke Address of Applicant 70 Park Street, Sydney, Cape Breton Co., NS Date 20 April 1947

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of John FrancisBurke

Born at Sydney in the County of Cape Breton

That John FrancisBurke Whose Birth is sought to be registered was

born at Sydney Cape Breton County on February 8, 1923

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

I am his mother with full knowledge of the event of his birth and I also attached a Church certificate of his birth and baptism.

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