JOHN F. TIERNEY FUNERAL HOME, INC.

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2001-01-01
Business code	812210
Sponsor’s telephone number	8606431222
Plan sponsor’s address	219 W CENTER STREET, MANCHESTER, CT, 060404857

Signature of

Role	Plan administrator
Date	2024-05-08
Name of individual signing	THOMAS TIERNEY
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2001-01-01
Business code	812210
Sponsor’s telephone number	8606431222
Plan sponsor’s address	219 W CENTER STREET, MANCHESTER, CT, 060404857

Signature of

Role	Plan administrator
Date	2023-07-28
Name of individual signing	THOMAS TIERNEY
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2001-01-01
Business code	812210
Sponsor’s telephone number	8606431222
Plan sponsor’s address	219 W CENTER STREET, MANCHESTER, CT, 060404857

Signature of

Role	Plan administrator
Date	2022-08-24
Name of individual signing	THOMAS TIERNEY
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2001-01-01
Business code	812210
Sponsor’s telephone number	8606431222
Plan sponsor’s address	219 WEST CENTER STREET, MANCHESTER, CT, 06040

Plan administrator’s name and address

Administrator’s EIN	060792257
Plan administrator’s name	JOHN F TIERNEY FUNERAL HOME
Plan administrator’s address	219 WEST CENTER STREET, MANCHESTER, CT, 06040
Administrator’s telephone number	8606431222

Signature of

Role	Plan administrator
Date	2011-09-09
Name of individual signing	JOHN F TIERNEY FUNERAL HOME
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2001-01-01
Business code	812210
Sponsor’s telephone number	8606431222
Plan sponsor’s address	219 WEST CENTER STREET, MANCHESTER, CT, 06040

Plan administrator’s name and address

Administrator’s EIN	060792257
Plan administrator’s name	JOHN F TIERNEY FUNERAL HOME
Plan administrator’s address	219 WEST CENTER STREET, MANCHESTER, CT, 06040
Administrator’s telephone number	8606431222

Signature of

Role	Plan administrator
Date	2010-08-10
Name of individual signing	JOHN F TIERNEY FUNERAL HOME
Valid signature	Filed with authorized/valid electronic signature