OBSTETRICS & GYNECOLOGY ASSOCIATES, P.C.

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1973-09-30
Business code	621111
Sponsor’s telephone number	2034535214
Plan sponsor’s address	652 BOSTON POST ROAD #17, GUILFORD, CT, 06437

Signature of

Role	Plan administrator
Date	2024-03-19
Name of individual signing	ERNESTINE CWIK
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2024-03-19
Name of individual signing	ERNESTINE CWIK
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1973-09-30
Business code	621111
Sponsor’s telephone number	2034535214
Plan sponsor’s address	652 BOSTON POST ROAD #17, GUILFORD, CT, 06437

Signature of

Role	Plan administrator
Date	2023-09-27
Name of individual signing	ERNESTINE CWIK
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2023-09-27
Name of individual signing	ERNESTINE CWIK
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1973-09-30
Business code	621111
Sponsor’s telephone number	2034535214
Plan sponsor’s address	652 BOSTON POST ROAD #17, GUILFORD, CT, 06437

Signature of

Role	Plan administrator
Date	2022-06-13
Name of individual signing	ERNESTINE CWIK
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1973-09-30
Business code	621111
Sponsor’s telephone number	2034535214
Plan sponsor’s address	652 BOSTON POST ROAD #17, GUILFORD, CT, 06437

Signature of

Role	Plan administrator
Date	2021-01-31
Name of individual signing	ERNESTINE CWIK
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2021-01-31
Name of individual signing	ERNESTINE CWIK
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1973-09-30
Business code	621111
Sponsor’s telephone number	2034535214
Plan sponsor’s address	652 BOSTON POST ROAD #17, GUILFORD, CT, 06437

Signature of

Role	Plan administrator
Date	2020-06-07
Name of individual signing	ERNESTINE CWIK
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2020-06-07
Name of individual signing	ERNESTINE CWIK
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1973-09-30
Business code	621111
Sponsor’s telephone number	2034535214
Plan sponsor’s address	652 BOSTON POST ROAD #17, GUILFORD, CT, 06437

Signature of

Role	Plan administrator
Date	2019-07-22
Name of individual signing	ERNESTINE CWIK
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1973-09-30
Business code	621111
Sponsor’s telephone number	2034535214
Plan sponsor’s address	652 BOSTON POST ROAD #17, GUILFORD, CT, 06437

Signature of

Role	Plan administrator
Date	2018-01-30
Name of individual signing	ERNESTINE CWIK
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1973-09-30
Business code	621111
Sponsor’s telephone number	2034535214
Plan sponsor’s address	652 BOSTON POST ROAD #17, GUILFORD, CT, 06437

Signature of

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

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1973-09-30
Business code	621111
Sponsor’s telephone number	2034535214
Plan sponsor’s address	652 BOSTON POST ROAD #17, GUILFORD, CT, 06437

Signature of

Role	Plan administrator
Date	2016-07-11
Name of individual signing	ERNESTINE CWIK
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1973-09-30
Business code	621111
Sponsor’s telephone number	2034535214
Plan sponsor’s address	652 BOSTON POST ROAD #17, GUILFORD, CT, 06437

Signature of

Role	Plan administrator
Date	2015-05-27
Name of individual signing	ERNESTINE CWIK
Valid signature	Filed with authorized/valid electronic signature