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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000482

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth October 20, 1923 Place of Birth SydneyCounty of Cape Breton

Name of Father Thomas James Burt MAIDEN NAME of Mother Mary Ann Anderson

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

Residence of Father when child was born Vulcan Avenue Sydney Cape Breton Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Steel Worker Place of birth of Father Rose Blanche, Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Myrtle Pyke Address of Applicant 575 Queenston Road, Hamilton, Ontario Date 8 November 1973

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That MyrtleBurt Whose Birth is sought to be registered was

born at Sydney Cape Breton County on October 20, 1923

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

My baptismal certificate which you have retained. Also my confirmation certificate.

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