INTEGRATED WELLNESS GROUP, LLC

Contact Information

POC	JESSICA MOMMENS
Phone	+1 203-387-9400
Fax	+1 888-772-2160
Address	446A BLAKE ST, NEW HAVEN, CT, 06515 4437, UNITED STATES

Ownership of Offeror Information

Highest Level Owner	Information not Available

Immediate Level Owner	Information not Available

List of Offerors (0)	Information not Available

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2014-01-01
Business code	621330
Sponsor’s telephone number	2033879400
Plan sponsor’s address	446A BLAKE STREET, SUITE 200, NEW HAVEN, CT, 06515

Signature of

Role	Plan administrator
Date	2020-11-05
Name of individual signing	MAYSA AKBAR
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2014-01-01
Business code	621330
Sponsor’s telephone number	2033879400
Plan sponsor’s address	446A BLAKE STREET, SUITE 200, NEW HAVEN, CT, 06515

Signature of

Role	Plan administrator
Date	2020-06-10
Name of individual signing	MAYSA AKBAR
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2014-01-01
Business code	621330
Sponsor’s telephone number	2033879400
Plan sponsor’s address	446A BLAKE STREET, SUITE 200, NEW HAVEN, CT, 06515

Signature of

Role	Plan administrator
Date	2019-04-23
Name of individual signing	MAYSA AKBAR
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2019-04-23
Name of individual signing	MAYSA AKBAR
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2014-01-01
Business code	621330
Sponsor’s telephone number	2033879400
Plan sponsor’s address	446A BLAKE STREET, SUITE 200, NEW HAVEN, CT, 06515

Signature of

Role	Plan administrator
Date	2018-10-04
Name of individual signing	MAYSA AKBAR
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2014-01-01
Business code	621330
Sponsor’s telephone number	2033879400
Plan sponsor’s address	446A BLAKE STREET, SUITE 200, NEW HAVEN, CT, 06515

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2014-01-01
Business code	621330
Sponsor’s telephone number	2033879400
Plan sponsor’s address	446A BLAKE STREET, SUITE 200, NEW HAVEN, CT, 06515

Signature of

Role	Plan administrator
Date	2016-06-14
Name of individual signing	MAYSA AKBAR
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2014-01-01
Business code	621330
Sponsor’s telephone number	2033879400
Plan sponsor’s address	446A BLAKE STREET, SUITE 200, NEW HAVEN, CT, 06515

Signature of

Role	Plan administrator
Date	2015-07-08
Name of individual signing	MAYSA AKBAR
Valid signature	Filed with authorized/valid electronic signature