SHORELINE PHYSICAL THERAPY, LLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1991-01-01
Business code	621340
Sponsor’s telephone number	8607394497
Plan sponsor’s mailing address	PO BOX 88, EAST LYME, CT, 06333
Plan sponsor’s address	131 BOSTON POST RD, EAST LYME, CT, 06333

Number of participants as of the end of the plan year

Active participants	0
Retired or separated participants receiving benefits	0
Other retired or separated participants entitled to future benefits	0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits	0
Number of participants with account balances as of the end of the plan year	0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	0

Signature of

Role	Plan administrator
Date	2016-10-03
Name of individual signing	JOANNE MOORE
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2016-10-03
Name of individual signing	JOANNE MOORE
Valid signature	Filed with authorized/valid electronic signature