DOUGLAS TUTHILL, D.V.M., P.C.

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1990-01-01
Business code	541940
Sponsor’s telephone number	8452944109
Plan sponsor’s mailing address	2555 ROUTE 207, CAMPBELL HALL, NY, 10916
Plan sponsor’s address	2555 ROUTE 207, CAMPBELL HALL, NY, 10916

Number of participants as of the end of the plan year

Active participants	0
Retired or separated participants receiving benefits	0
Other retired or separated participants entitled to future benefits	0
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	0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	0

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1990-01-01
Business code	541940
Sponsor’s telephone number	8452944109
Plan sponsor’s mailing address	2555 ROUTE 207, CAMPBELL HALL, NY, 10916
Plan sponsor’s address	2555 ROUTE 207, CAMPBELL HALL, NY, 10916

Number of participants as of the end of the plan year

Active participants	13
Number of participants with account balances as of the end of the plan year	13
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	0

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1990-01-01
Business code	541940
Sponsor’s telephone number	8452944109
Plan sponsor’s mailing address	2555 ROUTE 207, CAMPBELL HALL, NY, 10916
Plan sponsor’s address	2555 ROUTE 207, CAMPBELL HALL, NY, 10916

Number of participants as of the end of the plan year

Active participants	2
Retired or separated participants receiving benefits	0
Other retired or separated participants entitled to future benefits	11
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	13
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	2013-09-25
Name of individual signing	DOUGLAS TUTHILL
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2013-09-25
Name of individual signing	DOUGLAS TUTHILL
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1990-01-01
Business code	541940
Sponsor’s telephone number	8452944109
Plan sponsor’s mailing address	2555 ROUTE 207, CAMPBELL HALL, NY, 10916
Plan sponsor’s address	2555 ROUTE 207, CAMPBELL HALL, NY, 10916

Plan administrator’s name and address

Administrator’s EIN	141722129
Plan administrator’s name	DOUGLAS TUTHILL, D.V.M., P.C.
Plan administrator’s address	2555 ROUTE 207, CAMPBELL HALL, NY, 10916
Administrator’s telephone number	8452944109

Number of participants as of the end of the plan year

Active participants	8
Retired or separated participants receiving benefits	0
Other retired or separated participants entitled to future benefits	5
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	13
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	2012-05-23
Name of individual signing	DOUGLAS TUTHILL
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2012-05-23
Name of individual signing	DOUGLAS TUTHILL
Valid signature	Filed with authorized/valid electronic signature