James T. Grimes, Jr., DMD, P.A.

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2013-01-01
Business code	621210
Sponsor’s telephone number	3343473061
Plan sponsor’s address	11 INDIGO PLACE, ENTERPRISE, AL, 36330

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2013-01-01
Business code	621210
Sponsor’s telephone number	3343477358
Plan sponsor’s address	11 INDIGO PLACE, ENTERPRISE, AL, 36330

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1983-10-01
Business code	621210
Sponsor’s telephone number	3343473061
Plan sponsor’s address	11 INDIGO PLACE, ENTERPRISE, AL, 36330

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2013-01-01
Business code	621210
Sponsor’s telephone number	3343477358
Plan sponsor’s address	11 INDIGO PLACE, ENTERPRISE, AL, 36330

Signature of

Role	Plan administrator
Date	2015-07-23
Name of individual signing	JAMES T GRIMES

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2013-01-01
Business code	621210
Sponsor’s telephone number	3343473061
Plan sponsor’s address	P.O. BOX 311185, 551 GLOVER AVENUE, ENTERPRISE, AL, 363311185

Signature of

Role	Plan administrator
Date	2014-05-30
Name of individual signing	JAMES T GRIMES