FLOURISH PSYCHOLOGY PLLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2021-01-01
Business code	621330
Sponsor’s telephone number	9177379475
Plan sponsor’s address	300 CADMAN PLAZA WEST, FLOOR 12, BROOKLYN, NY, 11201

Signature of

Role	Plan administrator
Date	2024-06-04
Name of individual signing	SADI FOX

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2021-01-01
Business code	621330
Sponsor’s telephone number	9177379475
Plan sponsor’s address	300 CADMAN PLAZA WEST, FLOOR 12, BROOKLYN, NY, 11201

Signature of

Role	Plan administrator
Date	2023-05-22
Name of individual signing	SADI FOX

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2021-01-01
Business code	621330
Sponsor’s telephone number	9177379475
Plan sponsor’s address	300 CADMAN PLAZA WEST, FLOOR 12, BROOKLYN, NY, 11201

Signature of

Role	Plan administrator
Date	2022-05-06
Name of individual signing	SADI FOX