HEMPSTEAD MEDICAL GROUP PLLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2020-01-01
Business code	621111
Sponsor’s telephone number	6462695165
Plan sponsor’s address	2758 BIRCH AVENUE, EAST MEADOW, NY, 11554

Signature of

Role	Plan administrator
Date	2024-07-25
Name of individual signing	RUPAL SHAH

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2020-01-01
Business code	621111
Sponsor’s telephone number	6462695165
Plan sponsor’s address	2758 BIRCH AVENUE, EAST MEADOW, NY, 11554

Signature of

Role	Plan administrator
Date	2024-07-25
Name of individual signing	RUPAL SHAH

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2020-01-01
Business code	621111
Sponsor’s telephone number	6462695165
Plan sponsor’s address	2758 BIRCH AVENUE, EAST MEADOW, NY, 11554

Signature of

Role	Plan administrator
Date	2023-03-27
Name of individual signing	RUPAL SHAH

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2020-01-01
Business code	621111
Sponsor’s telephone number	6462695165
Plan sponsor’s address	2758 BIRCH AVENUE, EAST MEADOW, NY, 11554

Signature of

Role	Plan administrator
Date	2023-04-04
Name of individual signing	RUPAL SHAH

Three-digit plan number (PN)	002
Effective date of plan	2020-01-01
Business code	621111
Sponsor’s telephone number	6462695165
Plan sponsor’s address	2758 BIRCH AVENUE, EAST MEADOW, NY, 11554

Signature of

Role	Plan administrator
Date	2023-03-31
Name of individual signing	RUPAL SHAH

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2020-01-01
Business code	621111
Sponsor’s telephone number	6462695165
Plan sponsor’s address	2758 BIRCH AVENUE, EAST MEADOW, NY, 11554

Signature of

Role	Plan administrator
Date	2022-08-21
Name of individual signing	RUPAL SHAH