BROOKFIELD FAMILY DENTAL ART, LLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2012-01-01
Business code	621210
Sponsor’s telephone number	2037401014
Plan sponsor’s address	533 FEDERAL RD, BROOKFIELD, CT, 06804

Signature of

Role	Plan administrator
Date	2024-03-25
Name of individual signing	RAWA HASSAN
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2021-01-01
Business code	621210
Sponsor’s telephone number	2037401014
Plan sponsor’s address	533 FEDERAL RD, BROOKFIELD, CT, 06804

Signature of

Role	Plan administrator
Date	2024-03-25
Name of individual signing	RAWA HASSAN
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2012-01-01
Business code	621210
Sponsor’s telephone number	2037401014
Plan sponsor’s address	533 FEDERAL RD, BROOKFIELD, CT, 06804

Signature of

Role	Plan administrator
Date	2023-08-21
Name of individual signing	RAWA HASSAN
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2021-01-01
Business code	621210
Sponsor’s telephone number	2037401014
Plan sponsor’s address	533 FEDERAL RD, BROOKFIELD, CT, 06804

Signature of

Role	Plan administrator
Date	2023-07-15
Name of individual signing	RAWA HASSAN
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2021-01-01
Business code	621210
Sponsor’s telephone number	2037401014
Plan sponsor’s address	533 FEDERAL RD, BROOKFIELD, CT, 06804

Signature of

Role	Plan administrator
Date	2022-08-17
Name of individual signing	RAWA HASSAN
Valid signature	Filed with authorized/valid electronic signature