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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000581

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Helen LouiseLachowiez Sex Female

Date of Birth April 26, 1923 Place of Birth SydneyCounty of Cape Breton

Name of Father Michael Lachowiez MAIDEN NAME of Mother Annie Jane MacKinnon

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

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

Occupation of Father at Birth of child Steel Worker Place of birth of Father Poland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Helen Louise Lachowiez MacKinnon Address of Applicant 97 Castle Drive, Ball's Creek, Cape Breton Co., NS Date 23 September 1976

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Helen LouiseLachowiez

Born at Sydney in the County of Cape Breton

That Helen LouiseLachowiez Whose Birth is sought to be registered was

born at Sydney Cape Breton County on April 26, 1923

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

I am the applicant's uncle, being her late mother's brother and have personal knowledge of the applicant's birth date, as I was living at the date of birth in the city of Sydney, County of Cape Breton.

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