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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000150

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth July 7, 1923 Place of Birth DominionCounty of Cape Breton

Name of Father William Perehiniak MAIDEN NAME of Mother Margaret Stefura

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

Residence of Father when child was born Dominion Cape Breton Co. Ns Present address of Father Railroad Street, Dominion, Cape Breton Co., NS

Occupation of Father at Birth of child Coal Miner Place of birth of Father Poland, Europe

Race Name and present address of Physician in attendance at birth

Signature of Applicant Johanna Perehiniak Address of Applicant McLean Street, New Waterford, Cape Breton Co., NS Date 10 July 1952

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Dominion in the County of Cape Breton

That JohannaPerehiniak Whose Birth is sought to be registered was

born at Dominion Cape Breton County on July 7, 1923

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

I was a near neighbour of Mrs. Perehiniak who recorded the first information that she had given birth to a daughter who is now applying for a birth certificate. (Dr. certificate and baptism record)

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