BONE SEPTIC SERVICE, LLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2018-01-01
Business code	562000
Sponsor’s telephone number	5205606448
Plan sponsor’s address	10410 STATE ROUTE 662, LEWISPORT, KY, 42351

Signature of

Role	Plan administrator
Date	2022-06-01
Name of individual signing	MELINDA ROBBINS
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2018-01-01
Business code	562000
Sponsor’s telephone number	5205606448
Plan sponsor’s address	10410 STATE ROUTE 662, LEWISPORT, KY, 42351

Signature of

Role	Plan administrator
Date	2020-09-02
Name of individual signing	MELINDA ROBBINS
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2018-01-01
Sponsor’s telephone number	5205606448
Plan sponsor’s address	10410 STATE ROUTE 662, LEWISPORT, KY, 42351

Signature of

Role	Plan administrator
Date	2020-09-09
Name of individual signing	MELINDA ROBBINS
Valid signature	Filed with authorized/valid electronic signature