ANCHORAGE BARIATRICS, LLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2019-01-01
Business code	621111
Sponsor’s telephone number	9076448446
Plan sponsor’s address	3909 ARCTIC BOULEVARD, SUITE 101, ANCHORAGE, AK, 99503

Signature of

Role	Plan administrator
Date	2024-06-12
Name of individual signing	JUSTIN JAMES CLARK

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2019-01-01
Business code	621111
Sponsor’s telephone number	9076448446
Plan sponsor’s address	3909 ARCTIC BOULEVARD, SUITE 101, ANCHORAGE, AK, 99503

Signature of

Role	Plan administrator
Date	2023-03-22
Name of individual signing	JUSTIN JAMES CLARK

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2019-01-01
Business code	621111
Sponsor’s telephone number	9076448446
Plan sponsor’s address	3909 ARCTIC BLVD., STE. 101, ANCHORAGE, AK, 99503

Signature of

Role	Plan administrator
Date	2022-06-14
Name of individual signing	JUSTIN JAMES CLARK

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2019-01-01
Business code	621111
Sponsor’s telephone number	9076448446
Plan sponsor’s address	3909 ARCTIC BOULEVARD,, SUITE 101, ANCHORAGE, AK, 99503

Signature of

Role	Plan administrator
Date	2021-05-08
Name of individual signing	JUSTIN CLARK

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2019-01-01
Business code	621111
Sponsor’s telephone number	9076448446
Plan sponsor’s address	3909 ARCTIC BOULEVARD, SUITE 101, ANCHORAGE, AK, 99503

Signature of

Role	Plan administrator
Date	2020-04-26
Name of individual signing	JUSTIN CLARK