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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000516

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth September 8, 1924 Place of Birth Sydney MinesCounty of Cape Breton

Name of Father Joseph Glogowski MAIDEN NAME of Mother Elizabeth Matthews

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

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

Occupation of Father at Birth of child Coal Miner Place of birth of Father Hamborn, Germany

Race Name and present address of Physician in attendance at birth

Signature of Applicant Elizabeth Glogowski Address of Applicant 31 Church Street, Sydney Mines, Cape Breton Co., NS Date 7 September 1976

Relationship of Applicant to child Mother

AFFIDAVIT

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

Born at Sydney Mines in the County of Cape Breton

That MaryGlogowski Whose Birth is sought to be registered was

born at Sydney Mines Cape Breton County on September 8, 1924

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

See certificate of baptism

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