Ross A Marley, DMD, LLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2020-01-01
Business code	621210
Sponsor’s telephone number	9077476050
Plan sponsor’s address	308 ISLANDER DRIVE, SITKA, AK, 99835

Signature of

Role	Plan administrator
Date	2024-06-11
Name of individual signing	ROSS MARLEY

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2020-01-01
Business code	621210
Sponsor’s telephone number	9077476050
Plan sponsor’s address	308 ISLANDER DRIVE, SITKA, AK, 99835

Signature of

Role	Plan administrator
Date	2023-07-30
Name of individual signing	ROSS MARLEY

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2020-01-01
Business code	621210
Sponsor’s telephone number	9077476050
Plan sponsor’s address	308 ISLANDER DRIVE, SITKA, AK, 99835

Signature of

Role	Plan administrator
Date	2022-06-13
Name of individual signing	ROSS MARLEY

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2020-01-01
Business code	621210
Sponsor’s telephone number	9077476050
Plan sponsor’s address	308 ISLANDER DRIVE, SITKA, AK, 99835

Signature of

Role	Plan administrator
Date	2022-03-25
Name of individual signing	ROSS MARLEY
Role	Employer/plan sponsor
Date	2022-03-25
Name of individual signing	ROSS MARLEY

Three-digit plan number (PN)	001
Effective date of plan	2020-01-01
Sponsor’s telephone number	9077476050
Plan sponsor’s address	308 ISLANDER DRIVE, SITKA, AK, 99835

Signature of

Role	Plan administrator
Date	2022-03-25
Name of individual signing	ROSS MARLEY