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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100027

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth August 12, 1923 Place of Birth SydneyCounty of Cape Breton

Name of Father Stefan Pynisky MAIDEN NAME of Mother Pawlina Denys

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

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

Occupation of Father at Birth of child Steel Worker Place of birth of Father Podhajce, Ukraine

Race Name and present address of Physician in attendance at birth

Signature of Applicant Michael Pynisky Address of Applicant 564 Harmony Road South, Oshawa, Ontario, L1H 6V5 Date January 1988

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That MichaelPynisky Whose Birth is sought to be registered was

born at Sydney Cape Breton County on August 12, 1923

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

See attached general form of affidavit (with correct spelling of surname)

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