Advanced ENT and Allergy, PLLC

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Three-digit plan number (PN)	004
Effective date of plan	1989-10-01
Business code	621111
Sponsor’s telephone number	5028930159
Plan sponsor’s address	4004 DUPONT CIRCLE, STE 220, LOUISVILLE, KY, 402074819

Plan administrator’s name and address

Administrator’s EIN	270810245
Plan administrator’s name	ADVANCED ENT AND ALLERGY, PLLC
Plan administrator’s address	4004 DUPONT CIRCLE, STE 220, LOUISVILLE, KY, 402074819
Administrator’s telephone number	5028930159

Signature of

Role	Plan administrator
Date	2012-09-26
Name of individual signing	KENNETH M HODGE MD
Valid signature	Filed with authorized/valid electronic signature