NORMA GOMEZ DDS AND ASSOCIATES LLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2011-01-01
Business code	621210
Sponsor’s telephone number	2034810338
Plan sponsor’s address	144 NORTH MAIN STREET SUITE 8, BRANFORD, CT, 06405

Signature of

Role	Plan administrator
Date	2024-06-18
Name of individual signing	NORMA GOMEZ
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2011-01-01
Business code	621210
Sponsor’s telephone number	2034810338
Plan sponsor’s address	144 NORTH MAIN STREET SUITE 8, BRANFORD, CT, 06405

Signature of

Role	Plan administrator
Date	2024-06-18
Name of individual signing	NORMA GOMEZ
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2011-01-01
Business code	621210
Sponsor’s telephone number	2034810338
Plan sponsor’s address	144 NORTH MAIN STREET SUITE 8, BRANFORD, CT, 06405

Signature of

Role	Plan administrator
Date	2023-06-14
Name of individual signing	NORMA GOMEZ
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2011-01-01
Business code	621210
Sponsor’s telephone number	2034810338
Plan sponsor’s address	144 NORTH MAIN STREET SUITE 8, BRANFORD, CT, 06405

Signature of

Role	Plan administrator
Date	2022-07-11
Name of individual signing	NORMA GOMEZ
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2011-01-01
Business code	621210
Sponsor’s telephone number	2034810338
Plan sponsor’s address	144 NORTH MAIN STREET SUITE 8, BRANFORD, CT, 06405

Signature of

Role	Plan administrator
Date	2021-07-15
Name of individual signing	NORMA GOMEZ
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2021-07-15
Name of individual signing	NORMA GOMEZ
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2011-01-01
Business code	621210
Sponsor’s telephone number	2034810338
Plan sponsor’s address	144 NORTH MAIN STREET SUITE 8, BRANFORD, CT, 06405

Signature of

Role	Plan administrator
Date	2020-06-17
Name of individual signing	NORMA GOMEZ
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2020-06-17
Name of individual signing	NORMA GOMEZ
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2011-01-01
Business code	621210
Sponsor’s telephone number	2034810338
Plan sponsor’s address	144 NORTH MAIN STREET SUITE 8, BRANFORD, CT, 06405

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2011-01-01
Business code	621210
Sponsor’s telephone number	2034810338
Plan sponsor’s address	144 NORTH MAIN STREET SUITE 8, BRANFORD, CT, 06405

Signature of

Role	Plan administrator
Date	2018-10-15
Name of individual signing	NORMA GOMEZ
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2011-01-01
Business code	621210
Sponsor’s telephone number	2034810338
Plan sponsor’s address	144 NORTH MAIN STREET SUITE 8, BRANFORD, CT, 06405

Signature of

Role	Plan administrator
Date	2017-06-23
Name of individual signing	NORMA GOMEZ
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2011-01-01
Business code	621210
Sponsor’s telephone number	2034810338
Plan sponsor’s address	144 NORTH MAIN STREET, SUITE 8, BRANFORD, CT, 06405