MICHAEL M. MAKSYMIUK, D.M.D., LLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-11
Business code	621210
Sponsor’s telephone number	2037629480
Plan sponsor’s address	151 OLD RIDGEFIELD ROAD, SUITE 1, WILTON, CT, 06897

Signature of

Role	Plan administrator
Date	2024-10-07
Name of individual signing	MICHAEL M. MAKSYMIUK, D.M.D.
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-11
Business code	621210
Sponsor’s telephone number	2037629480
Plan sponsor’s address	151 OLD RIDGEFIELD ROAD, SUITE 1, WILTON, CT, 06897

Signature of

Role	Plan administrator
Date	2023-06-14
Name of individual signing	MICHAEL M. MAKSYMIUK, D.M.D.
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-11
Business code	621210
Sponsor’s telephone number	2037629480
Plan sponsor’s address	151 OLD RIDGEFIELD ROAD, SUITE 1, WILTON, CT, 06897

Signature of

Role	Plan administrator
Date	2022-04-20
Name of individual signing	MICHAEL M. MAKSYMIUK, D.M.D.
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-01
Business code	621210
Sponsor’s telephone number	2037629480
Plan sponsor’s address	151 OLD RIDGEFIELD ROAD, SUITE 1, WILTON, CT, 06897

Signature of

Role	Plan administrator
Date	2021-06-14
Name of individual signing	MICHAEL M. MAKSYMIUK, D.M.D.
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-01
Business code	621210
Sponsor’s telephone number	2037629480
Plan sponsor’s address	151 OLD RIDGEFIELD ROAD, SUITE 1, WILTON, CT, 06897

Signature of

Role	Plan administrator
Date	2020-07-21
Name of individual signing	MICHAEL M. MAKSYMIUK, D.M.D.
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-11
Business code	621210
Sponsor’s telephone number	2037629480
Plan sponsor’s address	151 OLD RIDGEFIELD ROAD, SUITE 1, WILTON, CT, 06897

Signature of

Role	Plan administrator
Date	2019-07-10
Name of individual signing	MICHAEL M. MAKSYMIUK, D.M.D.
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-11
Business code	621210
Sponsor’s telephone number	2037629480
Plan sponsor’s address	151 OLD RIDGEFIELD ROAD, SUITE 1, WILTON, CT, 06897

Signature of

Role	Plan administrator
Date	2018-07-10
Name of individual signing	MICHAEL MAKSYMIUK
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-11
Business code	621210
Sponsor’s telephone number	2037629480
Plan sponsor’s address	151 OLD RIDGEFIELD ROAD, SUITE 1, WILTON, CT, 06897

Signature of

Role	Plan administrator
Date	2017-07-24
Name of individual signing	MICHAEL MAKSYMIUK
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-11
Business code	621210
Sponsor’s telephone number	2037629480
Plan sponsor’s address	151 OLD RIDGEFIELD ROAD, WILTON, CT, 06897

Signature of

Role	Plan administrator
Date	2016-06-29
Name of individual signing	MICHAEL MAKSYMIUK
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-11
Business code	621210
Sponsor’s telephone number	2037629480
Plan sponsor’s address	151 OLD RIDGEFIELD ROAD, WILTON, CT, 06897

Signature of

Role	Plan administrator
Date	2015-07-22
Name of individual signing	MICHAEL MAKSYMIUK
Valid signature	Filed with authorized/valid electronic signature