MARIEL ELIZA, M.D., PLLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2021-01-01
Business code	621399
Sponsor’s telephone number	5162340073
Plan sponsor’s address	4 BUCKRAM RD, LOCUST VALLEY, NY, 11560

Plan administrator’s name and address

Administrator’s EIN	474474775
Plan administrator’s name	GUIDELINE, INC.
Plan administrator’s address	1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number	8882283491

Signature of

Role	Plan administrator
Date	2024-05-15
Name of individual signing	QIAN LIU

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2021-01-01
Business code	621399
Sponsor’s telephone number	5162340073
Plan sponsor’s address	4 BUCKRAM RD, LOCUST VALLEY, NY, 11560

Plan administrator’s name and address

Administrator’s EIN	474474775
Plan administrator’s name	GUIDELINE, INC.
Plan administrator’s address	1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number	8882283491

Signature of

Role	Plan administrator
Date	2023-06-15
Name of individual signing	CHRISTINE RIMER

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2021-01-01
Business code	621399
Sponsor’s telephone number	5162340073
Plan sponsor’s address	4 BUCKRAM RD, LOCUST VALLEY, NY, 11560

Plan administrator’s name and address

Administrator’s EIN	474474775
Plan administrator’s name	GUIDELINE, INC.
Plan administrator’s address	1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702
Administrator’s telephone number	8882283491

Signature of

Role	Plan administrator
Date	2022-07-07
Name of individual signing	CHRISTINE RIMER