MANDRAN HEALTH, PLLC

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Three-digit plan number (PN)	501
Effective date of plan	2022-06-01
Business code	621491
Sponsor’s telephone number	5022750035
Plan sponsor’s address	4010 DUPONT CIRCLE SUITE 411, LOUISVILLE, KY, 40207

Plan administrator’s name and address

Administrator’s EIN	846429706
Plan administrator’s name	SHAWNA BURTON
Plan administrator’s address	464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number	5026954700

Signature of

Role	Plan administrator
Date	2023-12-27
Name of individual signing	SHAWNA BURTON
Valid signature	Filed with authorized/valid electronic signature