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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000538

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Iwan JohnHomeniuk Sex Male

Date of Birth September 23, 1923 Place of Birth SydneyCounty of Cape Breton

Name of Father Myhaylo Homeniuk MAIDEN NAME of Mother Parascaevia Kosowych

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

Residence of Father when child was born Sydney Present address of Father deceased

Occupation of Father at Birth of child Steelworker Place of birth of Father Russia

Race Name and present address of Physician in attendance at birth

Signature of Applicant Iwan John Homeniuk Address of Applicant 1585 Kings Rd. Sydney Date September 19, 1975

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Iwan JohnHomeniuk

Born at Sydney in the County of Cape Breton

That Iwan JohnHomeniuk Whose Birth is sought to be registered was

born at Sydney Cape Breton County on September 23, 1923

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

Certificate of Baptism

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