CHARLES J. DICKGIESSER & CO., INC.

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2009-01-01
Business code	333200
Plan sponsor’s address	PO BOX 216, DERBY, CT, 064180216

Signature of

Role	Plan administrator
Date	2021-10-15
Name of individual signing	NANCY DICKGIESSER
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2021-10-15
Name of individual signing	NANCY DICKGIESSER
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2009-01-01
Business code	333200
Sponsor’s telephone number	1203734255
Plan sponsor’s DBA name	SAME
Plan sponsor’s address	PO BOX 216, DERBY, CT, 064180216

Signature of

Role	Plan administrator
Date	2020-07-30
Name of individual signing	NANCY DICKGIESSER
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2020-07-30
Name of individual signing	NANCY DICKGIESSER
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2009-01-01
Business code	333200
Sponsor’s telephone number	2037342553
Plan sponsor’s address	257 ROOSEVELT DR, DERBY, CT, 064181653

Signature of

Role	Plan administrator
Date	2019-07-11
Name of individual signing	NANCY L. DICKGIESSER
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2009-01-01
Business code	333200
Sponsor’s telephone number	2037342553
Plan sponsor’s address	257 ROOSEVELT DR, DERBY, CT, 064181653

Signature of

Role	Plan administrator
Date	2018-07-30
Name of individual signing	NANCY L. DICKGIESSER
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2009-01-01
Business code	333200
Sponsor’s telephone number	2037342553
Plan sponsor’s address	257 ROOSEVELT DR, DERBY, CT, 064181653

Signature of

Role	Plan administrator
Date	2017-07-26
Name of individual signing	NANCY DICKGIESSER
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2009-01-01
Business code	333200
Sponsor’s telephone number	2037342553
Plan sponsor’s address	257 ROOSEVELT DR, DERBY, CT, 064181653

Signature of

Role	Plan administrator
Date	2016-07-26
Name of individual signing	NANCY DICKGIESSER
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2009-01-01
Business code	333200
Sponsor’s telephone number	2037342553
Plan sponsor’s address	257 ROOSEVELT DR, DERBY, CT, 064181653

Signature of

Role	Plan administrator
Date	2015-07-24
Name of individual signing	NANCY L. DICKGIESSER
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2009-01-01
Business code	333200
Sponsor’s telephone number	2037342553
Plan sponsor’s address	257 ROOSEVELT DR, DERBY, CT, 064181653

Signature of

Role	Plan administrator
Date	2014-07-29
Name of individual signing	NANCY DICKGIESSER
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2009-01-01
Business code	333200
Sponsor’s telephone number	2037342553
Plan sponsor’s address	257 ROOSEVELT DR, DERBY, CT, 064181653

Signature of

Role	Plan administrator
Date	2013-07-31
Name of individual signing	CHARLES J DICKGIESSER CO INC
Valid signature	Filed with authorized/valid electronic signature