GEN OHKAWA DDS PLLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2019-01-01
Business code	452200
Sponsor’s telephone number	5186783111
Plan sponsor’s address	33 ROUTE 32A, SAUGERTIES, NY, 12477

Signature of

Role	Plan administrator
Date	2024-04-18
Name of individual signing	GEN OHKAWA

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2019-01-01
Business code	452200
Sponsor’s telephone number	5186783111
Plan sponsor’s address	33 ROUTE 32A, SAUGERTIES, NY, 12477

Signature of

Role	Plan administrator
Date	2023-05-04
Name of individual signing	EDWARD ROJAS

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2019-01-01
Business code	452200
Sponsor’s telephone number	5186783111
Plan sponsor’s address	33 ROUTE 32A, SAUGERTIES, NY, 12477

Signature of

Role	Plan administrator
Date	2022-05-12
Name of individual signing	GEN OHKAWA

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2019-01-01
Business code	452200
Sponsor’s telephone number	5186783111
Plan sponsor’s address	33 ROUTE 32A, SAUGERTIES, NY, 12477

Signature of

Role	Plan administrator
Date	2021-06-15
Name of individual signing	EDWARD ROJAS

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2019-01-01
Business code	452200
Sponsor’s telephone number	5186783111
Plan sponsor’s address	33 ROUTE 32A, SAUGERTIES, NY, 12477

Signature of

Role	Plan administrator
Date	2020-07-11
Name of individual signing	GEN OHKAWA