HUDSON COMMUNITY OPHTHALMOLOGY, P.C.

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1998-01-01
Business code	621111
Sponsor’s telephone number	9147376360
Plan sponsor’s mailing address	1983 CROMPOND ROAD, CORTLANDT MANOR, NY, 10567
Plan sponsor’s address	1983 CROMPOND ROAD, CORTLANDT MANOR, NY, 10567

Plan administrator’s name and address

Administrator’s EIN	133958394
Plan administrator’s name	HUDSON COMMUNITY OPHTHALMOLOGY, P.C.
Plan administrator’s address	1983 CROMPOND ROAD, CORTLANDT MANOR, NY, 10567
Administrator’s telephone number	9147376360

Number of participants as of the end of the plan year

Active participants	5
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	5
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	2011-02-22
Name of individual signing	LLOYD HOFFMAN
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2011-02-22
Name of individual signing	LLOYD HOFFMAN
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1998-01-01
Business code	621111
Sponsor’s telephone number	9147376360
Plan sponsor’s mailing address	1983 CROMPOND ROAD, CORTLANDT MANOR, NY, 10567
Plan sponsor’s address	1983 CROMPOND ROAD, CORTLANDT MANOR, NY, 10567

Plan administrator’s name and address

Administrator’s EIN	133958394
Plan administrator’s name	HUDSON COMMUNITY OPHTHALMOLOGY, P.C.
Plan administrator’s address	1983 CROMPOND ROAD, CORTLANDT MANOR, NY, 10567
Administrator’s telephone number	9147376360

Number of participants as of the end of the plan year

Active participants	5
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	5
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	2010-08-11
Name of individual signing	LLOYD HOFFMAN
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2010-08-11
Name of individual signing	LLOYD HOFFMAN
Valid signature	Filed with authorized/valid electronic signature