NEW AGE DENTAL, LLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2007-01-01
Business code	621210
Sponsor’s telephone number	8602328558
Plan sponsor’s address	47 MOUNTAIN FARMS ROAD, WEST HARTFORD, CT, 06117

Signature of

Role	Plan administrator
Date	2024-06-11
Name of individual signing	ELZBIETA W BASIL
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2007-01-01
Business code	621210
Sponsor’s telephone number	8602328558
Plan sponsor’s address	47 MOUNTAIN FARMS ROAD, WEST HARTFORD, CT, 06117

Signature of

Role	Plan administrator
Date	2023-07-20
Name of individual signing	ELZBIETA W BASIL
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2007-01-01
Business code	621210
Sponsor’s telephone number	8602328558
Plan sponsor’s address	47 MOUNTAIN FARMS ROAD, WEST HARTFORD, CT, 06117

Signature of

Role	Plan administrator
Date	2022-10-13
Name of individual signing	ELZBIETA W BASIL
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2007-01-01
Business code	621210
Sponsor’s telephone number	8602328558
Plan sponsor’s address	47 MOUNTAIN FARMS ROAD, WEST HARTFORD, CT, 06117

Signature of

Role	Plan administrator
Date	2021-09-24
Name of individual signing	ELZBIETA W BASIL
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2007-01-01
Business code	621210
Sponsor’s telephone number	8602328558
Plan sponsor’s address	47 MOUNTAIN FARMS ROAD, WEST HARTFORD, CT, 06117

Signature of

Role	Plan administrator
Date	2020-10-13
Name of individual signing	ELZBIETA W BASIL
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2007-01-01
Business code	621210
Sponsor’s telephone number	8602328558
Plan sponsor’s address	47 MOUNTAIN FARMS ROAD, WEST HARTFORD, CT, 06117

Signature of

Role	Plan administrator
Date	2019-10-04
Name of individual signing	ELZBIETA W BASIL
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2007-01-01
Business code	621210
Sponsor’s telephone number	8602328558
Plan sponsor’s address	47 MOUNTAIN FARMS ROAD, WEST HARTFORD, CT, 06117

Signature of

Role	Plan administrator
Date	2018-10-08
Name of individual signing	ELZBIETA W BASIL
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2007-01-01
Business code	621210
Sponsor’s telephone number	8602328558
Plan sponsor’s address	47 MOUNTAIN FARMS ROAD, WEST HARTFORD, CT, 06117

Signature of

Role	Plan administrator
Date	2017-10-03
Name of individual signing	ELZBIETA W BASIL
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2007-01-01
Business code	621210
Sponsor’s telephone number	8602328558
Plan sponsor’s address	47 MOUNTAIN FARMS ROAD, WEST HARTFORD, CT, 06117

Signature of

Role	Plan administrator
Date	2016-10-06
Name of individual signing	ELZBIETA W BASIL
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2007-01-01
Business code	621210
Sponsor’s telephone number	8602328558
Plan sponsor’s address	47 MOUNTAIN FARMS ROAD, WEST HARTFORD, CT, 06117

Signature of

Role	Plan administrator
Date	2015-10-16
Name of individual signing	ELZBIETA BASIL
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2015-10-16
Name of individual signing	ELZBIETA BASIL
Valid signature	Filed with authorized/valid electronic signature