E. ADAM LEYENS, PLLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2013-01-01
Business code	541110
Sponsor’s telephone number	5854734041
Plan sponsor’s address	1534 MONROE AVE, ROCHESTER, NY, 146181413

Signature of

Role	Plan administrator
Date	2017-10-03
Name of individual signing	EDGAR LEYENS

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2013-01-01
Business code	541110
Sponsor’s telephone number	5854734042
Plan sponsor’s address	1534 MONROE AVE, ROCHESTER, NY, 146181413

Signature of

Role	Plan administrator
Date	2015-05-26
Name of individual signing	EDGAR LEYENS

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2013-01-01
Business code	541110
Sponsor’s telephone number	5854734042
Plan sponsor’s address	1534 MONROE AVE, ROCHESTER, NY, 146181413

Signature of

Role	Plan administrator
Date	2014-05-29
Name of individual signing	EDGAR LEYENS