Empower Annuity Insurance Company

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Three-digit plan number (PN)	682
Sponsor’s telephone number	8003384015
Plan sponsor’s mailing address	8525 E. ORCHARD RD., 9T3, GREENWOOD VILLAGE, CO, 80111
Plan sponsor’s address	280 TRUMBULL ST., HARTFORD, CT, 06103

Signature of

Role	DFE
Date	2024-10-07
Name of individual signing	WANDA RUIZ
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	680
Sponsor’s telephone number	8003384015
Plan sponsor’s mailing address	8525 E. ORCHARD RD., 9T3, GREENWOOD VILLAGE, CO, 80111
Plan sponsor’s address	280 TRUMBULL ST., HARTFORD, CT, 06103

Signature of

Role	DFE
Date	2024-10-07
Name of individual signing	ALAN GREENE
Valid signature	Filed with authorized/valid electronic signature

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Three-digit plan number (PN)	827
Sponsor’s telephone number	8003384015
Plan sponsor’s mailing address	8525 E. ORCHARD RD., 9T3, GREENWOOD VILLAGE, CO, 80111
Plan sponsor’s address	280 TRUMBULL ST., HARTFORD, CT, 06103

Signature of

Role	DFE
Date	2024-10-07
Name of individual signing	ALAN GREENE
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	679
Sponsor’s telephone number	8003384015
Plan sponsor’s mailing address	8525 E. ORCHARD RD., 9T3, GREENWOOD VILLAGE, CO, 80111
Plan sponsor’s address	280 TRUMBULL ST., HARTFORD, CT, 06103

Signature of

Role	DFE
Date	2024-10-07
Name of individual signing	ALAN GREENE
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	449
Sponsor’s telephone number	8003384015
Plan sponsor’s mailing address	8525 E. ORCHARD RD., 9T3, GREENWOOD VILLAGE, CO, 80111
Plan sponsor’s address	280 TRUMBULL ST., HARTFORD, CT, 06103

Signature of

Role	DFE
Date	2024-10-07
Name of individual signing	DEANNE MONDRAGON
Valid signature	Filed with authorized/valid electronic signature

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Three-digit plan number (PN)	830
Sponsor’s telephone number	8003384015
Plan sponsor’s mailing address	8525 E. ORCHARD RD., 9T3, GREENWOOD VILLAGE, CO, 80111
Plan sponsor’s address	280 TRUMBULL ST., HARTFORD, CT, 06103

Signature of

Role	DFE
Date	2024-10-07
Name of individual signing	ALAN GREENE
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	038
Sponsor’s telephone number	8003384015
Plan sponsor’s mailing address	8525 E. ORCHARD RD., 9T3, GREENWOOD VILLAGE, CO, 80111
Plan sponsor’s address	280 TRUMBULL ST., HARTFORD, CT, 06103

Signature of

Role	DFE
Date	2024-10-09
Name of individual signing	WANDA RUIZ
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	684
Sponsor’s telephone number	8003384015
Plan sponsor’s mailing address	8525 E. ORCHARD RD., 9T3, GREENWOOD VILLAGE, CO, 80111
Plan sponsor’s address	280 TRUMBULL ST., HARTFORD, CT, 06103

Signature of

Role	DFE
Date	2024-10-07
Name of individual signing	WANDA RUIZ
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	514
Sponsor’s telephone number	8003384015
Plan sponsor’s mailing address	8525 E. ORCHARD RD., 9T3, GREENWOOD VILLAGE, CO, 80111
Plan sponsor’s address	280 TRUMBULL ST., HARTFORD, CT, 06103

Signature of

Role	DFE
Date	2024-10-07
Name of individual signing	DEANNE MONDRAGON
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	513
Sponsor’s telephone number	8003384015
Plan sponsor’s mailing address	8525 E. ORCHARD RD., 9T3, GREENWOOD VILLAGE, CO, 80111
Plan sponsor’s address	280 TRUMBULL ST., HARTFORD, CT, 06103

Signature of

Role	DFE
Date	2024-10-07
Name of individual signing	DEANNE MONDRAGON
Valid signature	Filed with authorized/valid electronic signature