GREENWICH UROLOGICAL ASSOCIATES, P.C.

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	1975-07-01
Business code	621111
Sponsor’s telephone number	2038691285
Plan sponsor’s address	49 LAKE AVENUE, GREENWICH, CT, 06830

Signature of

Role	Plan administrator
Date	2021-07-20
Name of individual signing	CATHERINE ALONZO, M.D.
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	1975-07-01
Business code	621111
Sponsor’s telephone number	2038691285
Plan sponsor’s address	49 LAKE AVENUE, GREENWICH, CT, 06830

Signature of

Role	Plan administrator
Date	2021-07-20
Name of individual signing	CATHERINE ALONZO, M.D.
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	1975-07-01
Business code	621111
Sponsor’s telephone number	2038691285
Plan sponsor’s address	49 LAKE AVENUE, GREENWICH, CT, 06830

Signature of

Role	Plan administrator
Date	2020-06-15
Name of individual signing	CATHERINE ALONZO, M.D.
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	1975-07-01
Business code	621111
Sponsor’s telephone number	2038691285
Plan sponsor’s address	49 LAKE AVENUE, GREENWICH, CT, 06830

Signature of

Role	Plan administrator
Date	2019-08-16
Name of individual signing	CATHERINE ALONZO, M.D.
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	1975-07-01
Business code	621111
Sponsor’s telephone number	2038691285
Plan sponsor’s address	49 LAKE AVENUE, GREENWICH, CT, 06830

Signature of

Role	Plan administrator
Date	2018-10-05
Name of individual signing	CATHERINE ALONZO, M.D.
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	1975-07-01
Business code	621111
Sponsor’s telephone number	2038691285
Plan sponsor’s address	49 LAKE AVENUE, GREENWICH, CT, 06830

Signature of

Role	Plan administrator
Date	2017-10-13
Name of individual signing	JEFFREY RANTA, M.D.
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	1975-07-01
Business code	621111
Sponsor’s telephone number	2038691285
Plan sponsor’s address	49 LAKE AVENUE, GREENWICH, CT, 06830

Signature of

Role	Plan administrator
Date	2016-09-22
Name of individual signing	JEFFREY RANTA, M.D.
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	1975-07-01
Business code	621111
Sponsor’s telephone number	2038691285
Plan sponsor’s address	49 LAKE AVENUE, GREENWICH, CT, 06830

Signature of

Role	Plan administrator
Date	2015-10-13
Name of individual signing	JEFFREY RANTA, M.D.
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	1975-07-01
Business code	621111
Sponsor’s telephone number	2038691285
Plan sponsor’s address	49 LAKE AVENUE, GREENWICH, CT, 06830

Signature of

Role	Plan administrator
Date	2014-10-06
Name of individual signing	JEFFREY RANTA, M.D.
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	1975-07-01
Business code	621111
Sponsor’s telephone number	2038691285
Plan sponsor’s address	49 LAKE AVENUE, GREENWICH, CT, 06830

Signature of

Role	Plan administrator
Date	2013-10-02
Name of individual signing	JEFFREY RANTA, M.D.
Valid signature	Filed with authorized/valid electronic signature