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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000396

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth July 9, 1923 Place of Birth SydneyCounty of Cape Breton

Name of Father Fred Theodore Melnyk MAIDEN NAME of Mother Carolina Dawyd

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 Sydney, Cape Breton Co., NS

Occupation of Father at Birth of child Steel worker Place of birth of Father Austria

Race Name and present address of Physician in attendance at birth

Signature of Applicant F. Melnyk Address of Applicant 164 Henry Street, Sydney, Cape Breton Co., NS Date 24 August 1970

Relationship of Applicant to child Father

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That MauriceMelnyk Whose Birth is sought to be registered was

born at Sydney Cape Breton County on July 9, 1923

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

I am his father and was present at the birth "Maurice is the anglicized form of Jaroslaus, the Baptismal name"

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