AJ DENTAL, LLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2018-01-01
Business code	621210
Sponsor’s telephone number	2039737400
Plan sponsor’s address	155 MAIN STREET SUITE 400, DANBURY, CT, 06810

Signature of

Role	Plan administrator
Date	2022-06-21
Name of individual signing	ERISSA FIDUCIARY SERVICES INC
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2018-01-01
Business code	621210
Sponsor’s telephone number	2039737400
Plan sponsor’s address	155 MAIN STREET SUITE 400, DANBURY, CT, 06810

Signature of

Role	Plan administrator
Date	2022-07-12
Name of individual signing	ERISA FIDUCIARY SERVICES, INC
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2018-01-01
Business code	621210
Sponsor’s telephone number	2039737400
Plan sponsor’s address	155 MAIN STREET SUITE 400, DANBURY, CT, 06810

Signature of

Role	Plan administrator
Date	2021-04-01
Name of individual signing	ERISA FIDUCIARY SERVICES
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2018-01-01
Business code	621210
Sponsor’s telephone number	2039737400
Plan sponsor’s address	155 MAIN STREET SUITE 400, DANBURY, CT, 06810

Signature of

Role	Plan administrator
Date	2020-04-09
Name of individual signing	ERISA FIDUCIARY SERVICES
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2018-01-01
Business code	621210
Sponsor’s telephone number	2039737400
Plan sponsor’s address	155 MAIN STREET SUITE 400, DANBURY, CT, 06810

Signature of

Role	Plan administrator
Date	2019-07-23
Name of individual signing	ERISA FIDUCIARY SERVICES, INC
Valid signature	Filed with authorized/valid electronic signature