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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000472

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mykyta (Mike)Yourkavich Sex Male

Date of Birth May 18, 1924 Place of Birth SydneyCounty of Cape Breton

Name of Father Ivan Yourkavich MAIDEN NAME of Mother Anna Zariwny

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

Residence of Father when child was born 1 Henry Street, Sydney, Cape Breton Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Labourer Place of birth of Father Ukraine

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mike Yourkavich Address of Applicant 170 Vanauley Walk, Apt. 601, Toronto, Ontario Date 20 June 1975

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mykyta (Mike)Yourkavich

Born at Sydney in the County of Cape Breton

That Mykyta (Mike)Yourkavich Whose Birth is sought to be registered was

born at Sydney Cape Breton County on May 18, 1924

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

His true copy of Certificate of Birth and Baptism issued by the Holy Ghost Church (Ukrainian Catholic) and which appears in the Baptismal register of said Church

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