DANIEL J. CAMERON M.D., P.C.

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1992-12-31
Business code	621111
Sponsor’s telephone number	9146664665
Plan sponsor’s mailing address	657 MAIN STREET, MT. KISCO, NY, 10549
Plan sponsor’s address	657 MAIN STREET, MT. KISCO, NY, 10549

Plan administrator’s name and address

Administrator’s EIN	133458028
Plan administrator’s name	DANIEL J. CAMERON, M.D., P.C.
Plan administrator’s address	657 MAIN STREET, MT. KISCO, NY, 10549
Administrator’s telephone number	9146664665

Number of participants as of the end of the plan year

Active participants	4
Retired or separated participants receiving benefits	0
Other retired or separated participants entitled to future benefits	4
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits	0
Number of participants with account balances as of the end of the plan year	8
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	0

Signature of

Role	Plan administrator
Date	2010-04-15
Name of individual signing	DANIEL CAMERON
Valid signature	Filed with authorized/valid electronic signature