Psychiatric Staffing, LLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2017-01-01
Business code	621112
Sponsor’s telephone number	3342392622
Plan sponsor’s address	233 WINTON BLOUNT LOOP, MONTGOMERY, AL, 36117

Signature of

Role	Plan administrator
Date	2021-10-13
Name of individual signing	SHANKAR YALAMANCHILI

Three-digit plan number (PN)	001
Effective date of plan	2017-01-01
Business code	621112
Sponsor’s telephone number	3342392622
Plan sponsor’s address	233 WINTON BLOUNT LOOP, MONTGOMERY, AL, 36117

Signature of

Role	Plan administrator
Date	2020-10-11
Name of individual signing	SHANKAR YALAMANCHILI

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2017-01-01
Business code	621112
Sponsor’s telephone number	3342392622
Plan sponsor’s address	233 WINTON BLOUNT LOOP, MONTGOMERY, AL, 36117

Signature of

Role	Plan administrator
Date	2021-01-05
Name of individual signing	SHANKAR YALAMANCHILI

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2017-01-01
Business code	621112
Sponsor’s telephone number	3342392622
Plan sponsor’s address	233 WINTON BLOUNT LOOP, MONTGOMERY, AL, 36117

Signature of

Role	Plan administrator
Date	2019-07-31
Name of individual signing	SHANKAR YALAMANCHILI

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2017-01-01
Business code	621112
Sponsor’s telephone number	3342392622
Plan sponsor’s address	233 WINTON BLOUNT LOOP, MONTGOMERY, AL, 36117

Signature of

Role	Plan administrator
Date	2018-10-04
Name of individual signing	SHANKAR YALAMANCHILI