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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000597

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth July 8, 1924 Place of Birth SydneyCounty of Cape Breton

Name of Father Paul Passnick MAIDEN NAME of Mother Halene Shickiva

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

Residence of Father when child was born Lingan Road, 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 John Passnick Address of Applicant General Delivery, Edmonton, Alberta Date 25 October 1978

Relationship of Applicant to child Brother

AFFIDAVIT

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

Born at Sydney in the County of Cape Breton

That PeterPassnick Whose Birth is sought to be registered was

born at Sydney Cape Breton County on July 8, 1924

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

I am the older brother of Peter and I remember his birth well. Mother is dead also.

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