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Questions? Please call a Fidelity retirement professional at 800-544-5373.

New Fidelity Account® — Retirement Plan Account

Complete this application to establish a Fidelity Retirement Plan account. This includes:
• Fidelity Self-employed 401(k) Plan Account • Fidelity Profit Sharing Plan Account • Fidelity Money Purchase Plan Account
Please fill in using CAPITAL letters and black ink. If you need more room for information or signatures, use a copy of the relevant page.

Important to Understand Helpful to Know

By signing this application, you acknowledge that: Regarding this account:
•F
 idelity Brokerage Services LLC (“FBS”) will perform •T
 here are three parties associated with a Fidelity® Retirement
brokerage and administrative services. Plan — the employer, the plan administrator, and the plan
•N
 ational Financial Services LLC (“NFS”) will maintain the assets participant. In many cases, the business owner may represent all
in a brokerage account and provide administrative services. three parties. Please complete this application accordingly.

•F
 idelity Management Trust Company (“FMTC”) will act as • To establish a new Fidelity Self-employed 401(k) Plan (“SE 401(k)
Plan Trustee. Plan”), to establish a new Profit Sharing Plan or Fidelity Money
Purchase Plan, or to amend any existing Fidelity Retirement
• FBS, NFS, and FMTC are together referred to herein as “Fidelity.” Plan, please complete the appropriate adoption agreement
• Fidelity® Government Cash Reserves will serve as the core enclosed with this application.
position (“Core Position”) for your account. •T  o modify the Plan Administrator on file for an existing plan,
•A  Fidelity Self-employed 401(k) Plan, Money Purchase Plan, and please complete the Fidelity Defined Contribution Retirement Plan
Profit Sharing Plan are hereby referred to collectively as a Fidelity Information Form, found on Fidelity.com.
Retirement Plan. • For additional information or for help filling out this application,
• Important documents related to your account include the Fidelity please call a Fidelity retirement professional at 800-544-5373.
Brokerage Retirement Customer Agreement (the “Customer
Agreement”), the underlying Fidelity Defined Contribution
Retirement Plan document and Adoption Agreement, as well as
other relevant information delivered from time to time.

1. Retirement Plan Information To be completed by employer.

Type of Plan

New Account — New Plan

Choose one ✔ Establish a new SE 401(k) Plan account
Establish a new Profit Sharing Plan account

Establish a new Money Purchase Plan account

Add an Account to an Existing Plan

Establish an account for an additional participant in an existing Money Purchase Plan or Profit Sharing Plan
Add spouse or an additional owner to an existing SE 401(k) Plan

Amend an Existing Plan

Amend an existing Profit Sharing Plan account to an SE 401(k) Plan account
Existing Account Number

Employer’s Plan Information

Employer Name

Plan Name e.g., ABC Company 401(k) Plan

Employer Taxpayer ID Number Existing Plan Tax ID Number

Retirement Plan Information continues on next page.

1.790776.125 Page 1 of 8 002301301

 1. Retirement Plan Information, continued

Plan Administrator Information This may be the Employer or a person designated by the Employer.
Plan Administrator
To amend existing plan
information already on
file, submit a Fidelity
Defined Contribution Plan Administrator Address
Retirement Plan
Information Form,
found on Fidelity.com. City State ZIP Code

Employer’s Signature

By signing below, you acknowledge that the information provided above is true and correct. You understand
that a completed applicable Fidelity Adoption Agreement must be submitted with this application if a new Fidelity
Retirement Plan is being established or an existing Profit Sharing Plan is being amended to a Self-employed
401(k) Plan.

PRINT NAME

EMPLOYER’S SIGNATURE

X
SIGN

TODAY’S DATE MM DD YYYY

D AT E

2. Participant Account Information To be completed by the participant.

Enter full first and last name First Name Middle Name Last Name
as evidenced by a government-
issued, unexpired document
(e.g., driver’s license, passport, Taxpayer ID Number Required Date of Birth MM DD YYYY
permanent resident card).
SSN/ITIN Entity ID/TIN
Mobile Phone Secondary Phone
Mobile phone number and
email are required for account
security, transactional alerts, Email
and delivery of other
communications.
By signing this account application, you agree to conduct business with Fidelity electronically and to the electronic
delivery of all account-related documents and communications. You consent to Fidelity’s use of your email and/or mobile
number to message, call, or text you for this purpose. Message and data rates apply; frequency may vary. For help with
texts, reply HELP. To opt out of texts, reply STOP. You may also update your contact information at any time through
your profile on Fidelity.com. Please look for an email to confirm your information and the terms of this consent.

Residential Address (where you live) This is your legal address used for tax reporting.
Street Address

City State ZIP Code

Mailing Address May be a PO box, drop box, or c/o location

 ame as legal/residential address
S Default if no other information indicated below.
Mailing Address

City State ZIP Code

Participant Account Information continues on next page.

1.790776.125 Page 2 of 8 002301302

 2. Participant Account Information, continued

Citizenship
✔ U
 .S. citizen Do not complete the fields below. Skip to Income Source.
Indicate your
citizenship status. Foreign citizen Information in this box must be completed.
Country of Citizenship

Choose one. Permanent U.S. resident Nonpermanent U.S. resident Nonresident of U.S.

Government Identification Number

ID Number Country of Issuance

Unexpired ID ID Issuance Date MM DD YYYY ID Expiration Date MM DD YYYY

must include reference
number and photo.
Attach copy of ID.
Passport Number Permanent Resident Identifier Other Government-Issued ID Number

Income Source Industry regulations require us to ask for this information.

Check one and ✔ E

 mployed: S
 elf-employed:
provide information. Occupation Employer Leave blank if self-employed.

Employer Address

City State/Province ZIP/Postal Code Country

Retired: Not employed:

Source of Income Pension, investments, spouse, etc.

Associations
As a person associated If you are employed by or associated with a broker-dealer, stock exchange, exchange member firm, the Financial
with a member firm, you Industry Regulatory Authority (FINRA), a municipal securities dealer, or other financial institution, or are the spouse or
are obligated to receive an immediate family member residing in the same household of someone who meets the aforementioned employment
consent from that firm. criteria, provide the company’s name and address below. Information (including duplicate copies of confirmations and
Fidelity has existing statements for this account, and any accounts you choose to have on a consolidated statement) will be sent to the asso-
consent agreements ciated person’s employer for purposes of compliance review.
with many firms for Company Name
their employees to
maintain accounts with
Fidelity and to deliver Company Address
transactional data. If
your firm is not one
of them, Fidelity will City State/Province ZIP/Postal Code Country
attempt to contact your
firm’s compliance office.
Affiliations
If you, your spouse, or any of your relatives (including parents, in-laws, and/or dependents, etc.), living in your home
(at the same address), is a member of the board of directors, a 10% shareholder, or a policy-making officer of a publicly
traded company (an “Affiliate”), you must provide the information below. If there are more than two Affiliates, make a
copy of this section.
Affiliate’s Company Name Trading Symbol or CUSIP

Affiliate’s Company Name Trading Symbol or CUSIP

Form continues on next page.

1.790776.125 Page 3 of 8 002301303

3. Initial Funding This is a one-time contribution.

Please indicate the method of funding to be used for your account (check all that apply).

Check Deposit Complete this section to make a one-time annual contribution.

By check payable to National Financial Services LLC. Checks for deposit should be mailed to the address at the
end of this application. Fidelity cannot accept third-party checks.
Employer contribution to PS, MP, or SE 401(k) Plan accounts
Amount

Employee contribution to SE 401(k) Plan account only

Current Year Prior Year
Amount Amount

Transfer Existing Mutual Fund Only Account Assets to Your New Retirement Plan Account
Complete the section below to transfer the assets you wish to use as a source for funding.

Transfer all assets from identically registered Mutual Fund Only account. Must have the same plan name, same
plan administrator, and the same participant.
Your Fidelity Mutual Fund Only Account Number

Transfer from Another Financial Institution

Complete an accompanying Fidelity Transfer of Assets Form and return it with this application.

Transfer of Assets from an outside Retirement Plan Amount

of Same Account Type

4. Beneficiaries
• Designate
 beneficiaries to receive payment of the value of the Retirement Plan account being established with this application following
your death. You may name one or more persons, trusts, or entities.
• This beneficiary designation applies to this account only and will not impact other Fidelity account beneficiary designations. Additionally, any
beneficiary designations you have made on other Fidelity accounts will not apply to this account. However, if you are transferring an existing
Fidelity Retirement Plan account to a Retirement Plan account, you may elect to apply your existing beneficiary designation to this account
by checking the box below.
• Leaving this section blank will indicate no beneficiary is named by you for this account and, upon your death, you agree to have the pay-
ment of the value of this account made to your surviving spouse or, if no surviving spouse, your estate. If more than one person is named
and no share percentages are indicated, payment shall be made in equal shares to your surviving primary beneficiary(ies). If a percentage
is indicated and a primary beneficiary does not survive you, the percentage of that beneficiary’s designated share shall be divided equally
among the surviving primary beneficiary(ies). If no primary beneficiaries survive you, payment will be made to any surviving contingent
beneficiaries according to the same rules of succession described above for primary beneficiaries.
• Do not name yourself as the beneficiary. You should identify who you want to succeed you on this account if assets remain in the account
after your death.
Copy Beneficiaries from Another Fidelity Retirement Plan Account
Available ONLY if you want to copy the current beneficiary designation(s) from an existing Fidelity Retirement Plan account.

Designate the SAME beneficiaries Your Fidelity Retirement Plan Account Number Skip to next section.
and percentages on this account
as are currently designated for:

Beneficiaries continues on next page.

1.790776.125 Page 4 of 8 002301304

 4. Beneficiaries, continued

Marital Status
Please indicate the Participant’s marital status.
Single
Married
If married and you designate a non-spouse beneficiary as your primary beneficiary, have your spouse sign the
Spousal Consent section on the next page in the presence of a notary public.

Primary Beneficiaries
For each beneficiary Spouse Name If naming spouse as a beneficiary, do so here.
you list by name,
check a beneficiary Non-Spouse
type and provide Trust Social Security or Taxpayer ID Number Date of Birth/Trust MM DD YYYY Share Percentage
all information. Per stirpes
Other Entity
If you outlive the
beneficiary and you Name
want that beneficia- Non-Spouse
ry’s share to go to
each of his or her Trust Social Security or Taxpayer ID Number Date of Birth/Trust MM DD YYYY Share Percentage
descendants by right Per stirpes
Other Entity
of representation,
check “per stirpes.”
Name
Non-Spouse
Trust Social Security or Taxpayer ID Number Date of Birth/Trust MM DD YYYY Share Percentage
Per stirpes
Other Entity

Total must add up to 100%. 0.00

Contingent Beneficiaries
Contingent beneficia- Spouse Name If naming spouse as a beneficiary, do so here.
ries receive assets only
if no primary beneficiary Non-Spouse
survives you. Trust Social Security or Taxpayer ID Number Date of Birth/Trust MM DD YYYY Share Percentage
Per stirpes
Do NOT list any primary
Other Entity
beneficiaries here.
Name
Non-Spouse
Trust Social Security or Taxpayer ID Number Date of Birth/Trust MM DD YYYY Share Percentage
Per stirpes
Other Entity

Name
Non-Spouse
Trust Social Security or Taxpayer ID Number Date of Birth/Trust MM DD YYYY Share Percentage
Per stirpes
Other Entity

Total must add up to 100%. 0.00

Beneficiaries continues on next page.

1.790776.125 Page 5 of 8 002301305

4. Beneficiaries, continued

Spousal Consent Notarized signature required only when the spouse is not listed as 100% primary beneficiary
You hereby consent to the designation of the primary beneficiary(ies) listed above. You understand that this consent allows the beneficiary(ies)
listed above to be paid amounts that would otherwise be paid to you.
PRINT NAME

SIGNATURE OF PARTICIPANT’S SPOUSE

X
SIGN

TODAY’S DATE MM DD YYYY

DAT E

Important Note: CA Notaries are permitted to submit a separate page notary document. If used, it must identify the
document being notarized.

Notice to CA Residents: A Notary Public or other officer completing this certificate verifies only the identity of the individual
who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
Certificate of Acknowledgement of Notary Public Must be a U.S. Notary. Foreign notary or consular seals may NOT be substituted.

State of , in the County of , subscribed and sworn to before me by the

above-named Co-Fiduciary who is personally known to me or who has produced as identification,

that the foregoing statements were true and accurate and made of his/her own free act and deed, on / / .

Print Notary Name NOTARY SEAL / STAMP

Notary Signature Date MM DD YYYY

SIGN

My commission expires / / .

5. Participant and Plan Administrator Signatures and Dates

Participant Agreement:
By signing below, you:
•C  onsent to the information, instructions, •A  gree that upon transfer of assets due to •A
 cknowledge that you agree to the use
and provisions set forth in this account any life event (divorce, death, etc.), and of the Core Position to hold any assets of
application and to the beneficiary(ies) you unless otherwise instructed, all residual your account pending investment or other
have designated in the application. income paid to the account and any instructions and that you have received and
•U  nderstand that payment to the fractional shares will be systematically read the prospectus for the Core Position.
beneficiary(ies) will be made according allocated to the Transferee (New Asset •U
 nderstand that your Core Position is a
to the rules of succession described in Holder) receiving the largest share money market fund, and that you could
the beneficiary section of this account proportion of the account assets. If the lose money by investing in a money
application. account is transferred evenly, or at different market fund. Although the fund seeks to
intervals, the income and/or fractional preserve the value of your investment at
• Acknowledge that you received the shares will be systematically allocated to
Customer Agreement and the underlying $1.00 per share, it cannot guarantee it
the last transferee paid. will do so. An investment in the fund is
Fidelity Defined Contribution Retirement
Plan document and Adoption Agreement, • Certify that you are of legal age to enter not insured or guaranteed by the Federal
that you have read and understand both; this agreement. Deposit Insurance Corporation or any
and that you agree to all terms and • Certify that all information provided in this other government agency. Fidelity
conditions on this application and in the application is true, accurate, and complete. Investments and its affiliates, the fund’s
above agreements, as these agreements sponsor, have no legal obligation to
may be amended from time to time. provide financial support to money
market funds and you should not expect
that the sponsor will provide financial
support to the fund at any time.

Participant and Plan Administrator Signatures and Dates continues on next page.

1.790776.125 Page 6 of 8 002301306

5. Participant and Plan Administrator Signatures and Dates, continued

•C
 onsent to have only one copy of Fidelity •U  nderstand that, upon an issuer’s request •A  gree to be responsible for any and all fees
mutual fund shareholder documents, such in accordance with applicable rules and and charges that apply to the account.
as prospectuses and shareholder reports regulations, Fidelity will supply your name • Certify and agree that the certifications,
(“Documents”), delivered to you and any to issuers of any securities held in your authorizations, and appointments in this
other investors sharing your address. Your account so you might receive any important document will continue until Fidelity receives
Documents, if held in eligible accounts, information regarding them, unless you actual written notice of any change thereof.
will be householded indefinitely; however, notify Fidelity.
you may revoke this consent at any time • Acknowledge that you will receive a
• Understand that it is your responsibility to monthly account statement from Fidelity,
by contacting Fidelity at 800-343-3548 read the prospectus for the Core Position.
and you will begin receiving multiple unless there are no transactions in a
copies within 30 days. As Documents for • Hereby constitute and appoint Fidelity your particular month. In any case, you will
other investments become available in the true and lawful attorney to surrender for receive a statement quarterly.
future, these Documents may also be redemption any and all shares held in your If you are not a U.S. person:
householded in accordance with this account with full power of substitution in
the premises, and further acknowledge that • State that you are submitting IRS
authorization or any notice or agreement Form W-8BEN with this application to
you received or entered into with Fidelity Fidelity may cease to act as agent to the
above appointment after providing notice certify your foreign status and, if applicable,
or its service providers. to claim tax treaty benefits.
to your account’s address of record.

To help the government fight financial crimes, Federal regulation requires Fidelity to obtain your name, date of birth, address, and a
government-issued ID number before opening your account, and to verify the information. In certain circumstances, Fidelity may obtain
and verify comparable information for any person authorized to make transactions in an account. Also, Federal regulation requires Fidelity
to obtain and verify the beneficial owners and control persons of legal entity customers. Requiring the disclosure of key individuals who own
or control a legal entity helps law enforcement investigate and prosecute crimes. Your account may be restricted or closed if Fidelity cannot
obtain and verify this information. Fidelity will not be responsible for any losses or damages (including, but not limited to, lost opportunities)
that may result if your account is restricted or closed.

I acknowledge that this account is governed by a predispute arbitration clause, which appears on the last page of the Customer
Agreement, and that I have read the predispute arbitration clause.

By signing below, you acknowledge that you have read, understand, and agree to be bound by the provisions of this application.

PRINT PARTICIPANT’S NAME PRINT PLAN ADMINISTRATOR’S NAME

PARTICIPANT’S SIGNATURE PLAN ADMINISTRATOR’S SIGNATURE

X X
SIGN
SIGN

TODAY’S DATE MM DD YYYY TODAY’S DATE MM DD YYYY

D AT E
D AT E

441123.16.0

1.790776.125 Page 7 of 8 002301307

 Before submitting this application:
If you are establishing a new SE 401(k) Plan, Profit Sharing Plan, or Money Purchase Plan, or amending any existing
retirement plan, complete and attach:
The enclosed corresponding Adoption Agreement.
Be sure that you:
Include a Transfer of Assets form, if transferring funds from another firm.
Include a check to fund your account, if funding by a check.
Remember to sign this application.
Need additional space? Make a copy of the relevant section.

Did you sign the form and attach any necessary documents? Regular mail Overnight mail
Return your completed application and any attachments to Fidelity. Fidelity Investments Fidelity Investments
You will receive a “New Account Profile” confirming that your account PO Box 770001 100 Crosby Parkway KC1K
is opened. Cincinnati, OH 45277-0036 Covington, KY 41015
Questions? Please call a Fidelity retirement professional at 800-544-5373.

Brokerage services are provided by Fidelity Brokerage Services LLC. Custody and other services are provided by National Financial
Services LLC. Both are Fidelity Investments companies and members of NYSE and SIPC.
Fidelity Brokerage Services LLC, Member NYSE and SIPC, 900 Salem Street, Smithfield, RI 02917
© 2024 FMR LLC. All rights reserved. 441123.16.0 (03/24)

1.790776.125 Page 8 of 8 002301308

 Print Reset Save

Questions? Go to Fidelity.com/trustedcontact or call 800-343-3548.

Trusted Contact Authorization Form

Use this form to designate a primary and alternate trusted contact, that is 18 years or older, for your Fidelity account(s). Do NOT use
this form for charitable giving accounts or workplace retirement plans, such as a 401(k). Type on screen or fill in using CAPITAL letters and
black ink. If you need more room for information or signatures, make a copy of the relevant page.

Helpful to Know
• To prepare yourself and your trusted contact(s) for success, • If Fidelity has questions or concerns about your health or welfare
consider choosing someone with whom you are comfortable due to potential diminished capacity, financial exploitation or
discussing your health, relationships, loved ones, work, abuse, endangerment, and/or neglect, this form authorizes us to
and finances. You may also want to consider selecting get in touch with the trusted contact(s) and:
someone who isn’t currently involved in your financial life, – Provide the trusted contact(s) listed below with information
like a beneficiary or power of attorney, to ensure fairness about you and/or your account(s), including notice of a
and objectivity. temporary hold, but does not provide him or her with the
• This form supersedes any previous trusted contact ability to transact on your account(s).
designations that you may have submitted. – Inquire about your current contact information or
• If you are using this form for an Entity relationship (for ex: a health status.
business account), we will assign the Trusted Contact(s) to the – Inquire about whether another person or entity has legal
Authorized Individual that signs this form. authority to act on your behalf (e.g., legal guardian or
conservator, executor, or trustee).

1. Account Owner
First Name Middle Name Last Name

Social Security or Taxpayer ID Number

2. Accounts Included
Check only one. ALL eligible accounts associated with the above Social Security or Taxpayer ID Number Skip to Section 3.
ONLY the account(s) listed below:
Fidelity Account Number Fidelity Account Number Fidelity Account Number

Fidelity Account Number Fidelity Account Number Fidelity Account Number

3. Primary Trusted Contact Name, email, phone, and address are all required.
The trusted contact First Name Middle Name Last Name
MUST be someone
other than the individual
listed in Section 1. Do Email Relationship to Owner (Spouse, Child, Parent, Sibling, Friend, Other)
not provide the account
owner’s information here.
Primary Phone Secondary Phone
Mobile Mobile
Number Number

Legal/Permanent Address
Street Address
This cannot be a
PO box, mail drop,
or c/o.
City State/Province ZIP/Postal Code Country

Form continues on next page.

1.9883825.102 Page 1 of 2 037430201

 4. Alternate Trusted Contact Name, email, phone, and address are all required.
The trusted contact First Name Middle Name Last Name
MUST be someone other
than the individuals listed
in Sections 1 and 3. Do Email Relationship to Owner (Spouse, Child, Parent, Sibling, Friend, Other)
not provide the account
owner’s information here.
Primary Phone Secondary Phone
Mobile Mobile
Number Number

Legal/Permanent Address
Street Address
This cannot be a
PO box, mail drop,
or c/o.
City State/Province ZIP/Postal Code Country

5. Signature and Date Form cannot be processed without your signature and date.

By signing below, you:

• Authorize Fidelity to communicate with • Understand that this does not authorize in writing to one of the business addresses
your trusted contact(s) and disclose your trusted contact(s) to separately access listed below.
information about designated accounts or transact on your account(s). • Understand that you may change
to address possible financial exploitation • Understand that you may identify multiple your trusted contact(s) at any time by
or confirm specifics about your current trusted contacts on this form, provided completing a new form.
contact information, your health status, or they are 18 years or older.
the identity of any legal guardian, executor, • Certify that all information provided in this
trustee, or holder of a power of attorney, or • Understand that this trusted contact form is true, accurate, and complete.
as otherwise permitted. designation is optional and you may • Acknowledge that we may remove any
withdraw it at any time by notifying Fidelity trusted contact from any account, at any
time or for any reason.

PRINT OWNER/AUTHORIZED INDIVIDUAL NAME

OWNER/AUTHORIZED INDIVIDUAL SIGNATURE DATE MM/DD/YYYY

X X
SIGN

Did you sign the form? Send the ENTIRE form to Fidelity. Regular mail Overnight mail
Fidelity Investments Fidelity Investments
Questions? Go to Fidelity.com/trustedcontact or call 800-343-3548. PO Box 770001 100 Crosby Parkway KC1K
Cincinnati, OH 45277-0002 Covington, KY 41015

On this form, “Fidelity” means Fidelity Brokerage Services LLC and its affiliates. Brokerage services are
provided by Fidelity Brokerage Services LLC, Member NYSE, SIPC. 802990.3.0 (06/20)

1.9883825.102 Page 2 of 2 037430202

 Questions? Go to Fidelity.com/se401k or call 800-544-5373.

The Defined Contribution Retirement Plan —

Self-Employed 401(k) Adoption Agreement Instructions
Complete the Profit Sharing/401(k) Plan Adoption Agreement No. 001 to adopt or amend the Defined Contribution Retirement
Self-Employed 401(k) Plan. This is a pre-approved plan for use with the Defined Contribution Retirement Plan, Basic Plan Document No. 04.

Helpful to Know
• The Adoption Agreement should be completed by the • It is recommended that you also appoint a Successor
Employer. Plan Administrator to act on behalf of the Plan in the
event that the named Plan Administrator dies, resigns,
• A Plan Administrator must be appointed for your Plan.
or is otherwise unable or unwilling to act on the behalf
The Employer may serve as the Plan Administrator,
of the Plan. The Successor Plan Administrator must also
or you can designate another individual to administer
be a person and not a company.
the Plan on your behalf and to serve as the main
contact with Fidelity. Do not list a company as the Plan • To learn more about the duties of the Plan Administrator
Administrator. The Plan Administrator is a “named or Successor Plan Administrator, refer to Section 11.2(b)
fiduciary” for purposes of ERISA Section 402(a)(1) and of the Plan Document.
has the powers and responsibilities with respect to the
• You should keep a copy of the completed Adoption
management and operation of your company’s Plan.
Agreement for your permanent company records.

1. Plan Information
A. Enter the legal name of the Plan.
• For a sole proprietor with no business name, you can use your name as the name of the Plan, for example, the “John Smith
Self-Employed 401(k) Plan.”
• For an amendment of a previously adopted Plan, fill in the existing name of the Plan.
Enter the three-digit Plan Number.
• This number is assigned to the Plan by the Employer and is a requirement of the Internal Revenue Service.
• For a new plan, and if you have never maintained another qualified retirement plan, this Plan Number is “001.”
• If you currently have or have ever maintained any other qualified retirement plan(s), this Plan Number should follow consecutively
(for example, your first Plan is 001, the next Plan is 002, and so on).
B. Enter the requested contact information for the appointed Plan Administrator.
• The Plan Administrator is typically the Employer, but can be another individual designated by the Employer. Do not list a company.
• The Plan Administrator will be responsible for administering your company’s Plan, ensuring that the Plan is operating according to the
Plan Document, and will serve as the main contact with Fidelity. Fidelity will use the provided Plan Administrator contact information
to provide any future notices regarding amendments to the Fidelity Retirement Plan, as well as the Annual Valuation Statement mailing
each year that is designed to help you complete your Form 5500 or 5500-EZ annual report.
• You should also name a second individual as a Successor Plan Administrator who will assume the responsibilities of the Plan
Administrator in the event that the Plan Administrator is unable or unwilling to fulfill its duties on behalf of the Plan.
C. The type of plan has already been preselected.
D. Check either Calendar Year or Fiscal Year as the Plan Year for your Plan. If Fiscal Year, provide your fiscal-year ending date.
E. Indicate the Plan’s Status and Effective Date.
(1) For a new Plan, check Box 1 and provide the Plan Effective Date.*
(2) To amend or restate an existing Plan, check Box 2 and provide both the Amendment Effective Date* and the Original Plan
Effective Date.
– If you are amending from an existing Fidelity Self-Employed 401(k), Profit Sharing, or Money Purchase Retirement Plan,
check Box E.2.a.
– If you are amending from an existing plan that is not a Fidelity Retirement Plan, check Box E.2.b. — You only need to provide the
Effective Date of 401(k) Contributions if you are permitting Eligible Participants to make elective contributions for the first time.
*If you want to be able to calculate contribution amounts based on a full year’s Compensation for the current Plan Year, use the first day
of the current Plan Year as your Effective Date.

Instructions continue on next page.

1.821762.105 Page 1 of 2
2. Employer
A. Provide the required information for your company.
• Enter the company’s Employer (Tax) Identification Number (EIN).
• Do not enter your Social Security Number. To obtain an EIN for your Plan, you can file IRS Form SS-4 or call the IRS directly at
800-829-4933.
B. If you are part of an affiliated group of Employers, as defined in Section 2.3 of the Plan Document (collectively defined as “Affiliated
Employers”), then all Affiliated Employers must be included in the Plan and listed in this section.
Unrelated Employers cannot be included as part of your Plan. Please consult your tax attorney and/or accountant for assistance on the
definition of Affiliated Employers.

3. Coverage
A. Indicate the requirements an Employee must complete with your company (including Affiliated Employers) to be eligible to participate
in the Plan.
(1) Choose the required length of service.
(2) Choose the age an Employee must attain before he or she may participate in the Plan.
B. Indicate the date an eligible employee will first become a Participant in the Plan.
C. Indicate how the elected service and age requirements will apply to Employees, including any current owner(s) and/or officer(s) of
the company:
• Check the first box if applicable to all current and future Employees.
• Check the second box if applicable to all Employees, except those employed on the Effective Date. Such Employees will participate
immediately. All other Employees will need to satisfy the requirements listed above.

4. Compensation
This provision allows you to elect what portion of Compensation is includable for the first year an eligible Employee becomes an active
Participant in the Plan. Be certain that any annual contribution amounts calculated for active Participants meet the “top-heavy minimum
contribution” amount, which is generally 3% of a Participant’s full-year Compensation. You are encouraged to consult with your tax advisor
when calculating contribution amounts.

5. Discretionary Nonelective Employer Contributions

The Plan allows for discretionary nonelective Employer Profit Sharing Contributions, and this section provides the option of integrating
these contributions with Social Security.
• Social Security Integration (permitted disparity) is designed for multi-participant plans and is not generally appropriate for a Self-
Employed 401(k) Retirement Plan, self-employed individuals, or owner-only businesses.
• You can check Box A to indicate that Contributions will not be integrated with Social Security, or consult a tax advisor first to determine
what is appropriate for your Plan.

6. Normal Retirement Age

You can skip this section unless the Plan adopted a Normal Retirement Age of 55 before January 1, 2009. Unless you previously adopted
age 55 as the Plan’s Normal Retirement Age, the Normal Retirement Age is age 59½.

7. Multiple Qualified Plans

You can skip this section if you are only operating one qualified plan.

8. Reliance on Opinion Letter

FMR LLC has obtained an “opinion letter” from the Internal Revenue Service for the Defined Contribution Retirement Plan, Basic
Plan Document No. 04. A copy of the opinion letter is included with the Plan Document. In certain cases, you may wish to apply for a
Determination Letter for your Plan. Please refer to the Adoption Agreement and Plan Document for further details. Consult your attorney
or accountant for further information.

9. Provider Information
FMR LLC serves as the Provider of the preapproved Plan Document.

10. Execution Page

The Employer must sign and date the Adoption Agreement before returning it to Fidelity.

On this form, “Fidelity” means Fidelity Brokerage Services LLC and its affiliates. Brokerage services are
provided by Fidelity Brokerage Services LLC, Member NYSE, SIPC. 353784.6.0 (11/20)

1.821762.105 Page 2 of 2
 Print Reset Save

Questions? Go to Fidelity.com/se401k or call 800-544-5373.

The Defined Contribution Retirement Plan —

Profit Sharing/401(k) Plan Adoption Agreement No. 001
A pre-approved plan for use with the Defined Contribution Retirement Plan, Basic Plan Document No. 04

1. Plan Information
A. Name of Plan:
This is the
(the “Plan”)

Plan Number

The Plan consists of the Basic Plan Document, this Adoption Agreement as completed, and the separate
Trust Agreement.

B. Name of Plan Administrator (if not the Employer):

Name

Address

City State ZIP Code

Telephone Number Email Address

The Plan Administrator serves as the main contact for the Plan and the designated agent for service of legal process
for the Plan.

Name of Successor Plan Administrator:

Name

Address

City State ZIP Code

Telephone Number Email Address

[Note: The failure to name a successor Plan Administrator may result in the delay of Plan distributions, if the Plan
Administrator is unable to fulfill its duties.]

Plan Information continues on next page.

1.866722.106 Page 1 of 6 032970201

1. Plan Information, continued

C. Type of Plan:
Check one. 1. Profit Sharing only — Elective Contributions (401(k) contributions) are not permitted. The Employer may
make Nonelective Employer Contributions in the manner elected in this Adoption Agreement.
2. Safe Harbor 401(k) Plan — Elective Contributions (401(k) contributions) are permitted and the Employer
will make Safe Harbor Nonelective Employer Contributions to the Plan on behalf of Eligible Participants
equal to 3% of their “Compensation” for the Plan Year. The Employer may make Nonelective Employer
Contributions in the manner elected in this Adoption Agreement.
 3. Non-Safe Harbor 401(k) Plan — Elective Contributions (401(k) contributions) are permitted. The Employer
will not make Safe Harbor Nonelective Employer Contributions to the Plan. The Employer may make
Nonelective Employer Contributions in the manner elected in this Adoption Agreement.

D. Plan Year and Limitation Year:

Check one. ✔ 1. Calendar Year 2. Fiscal Year ending MM DD

[Note: If left blank, the Plan Year and Limitation Year will be the calendar year.]

E. Plan Status and Effective Date:

Check one. 1. New Plan Effective Date: Date MM DD YYYY [Note: Cannot be earlier than the
first day of the current Plan Year.]

2. Amendment Effective Date: Date MM DD YYYY [Note: Cannot be earlier than the
first day of the current Plan Year.]

This is:

Check one. a. an amendment and restatement of a Basic Plan Document No. 04 Adoption Agreement previously
executed by the Employer. With the execution of this restatement, the Trust Agreement formerly
within Basic Plan Document No. 04 is hereby removed to become a separate, independent Trust
Agreement without altering the substance thereof.

b. an amendment and restatement from another plan document to a Basic Plan Document No. 04
Adoption Agreement.
The original effective date of the Plan MM DD YYYY

Complete if adding Elective Contributions (401(k) contributions) to your Plan for the first time:
Effective date of Elective Contributions: Date MM DD YYYY [Note: Cannot be earlier than the day this
amended Adoption Agreement is signed.]

2. Employer
A.
Name of Employer

Address

City State ZIP Code

Telephone Number Employer’s Tax Identification Number

Employer continues on next page.

1.866722.106 Page 2 of 6 032970202

2. Employer, continued

B. The term “Employer” includes the following Affiliated Employers covered by the Plan:

[Note: All Affiliated Employers are required to be covered under the terms of the Plan.]

3. Coverage
A. The eligibility requirements for participation in the Plan will be:
1. Eligibility Service Requirement:
Check one. a. No eligibility service requirement.
b. Six months of employment. (If this option is selected, an Employee will not be required to complete
any specified number of Hours of Service in the six-month period.)
c. One Year of Service.
d. Two Years of Service. (This option may only be selected if Section 1.C.1, Profit Sharing only, is selected
above. This option may not be selected if the Plan provides for Elective Contributions (401(k) contributions).)

2. Age Requirement:
Check one. a. No minimum age requirement.

b. Years (Cannot be more than 21.)

B. An Employee who has satisfied the eligibility requirements for participation in Section 3.A above will become a
Participant on the following date, provided he is an Employee:
Check one. 1. On the first day of the calendar month in which such requirements are satisfied.
2. On the first day of the Plan Year and the first day of the seventh month of the Plan Year (whichever is
earlier) coinciding with or immediately following the date on which such requirements are satisfied.

C. The requirements listed above are:

Check one. 1. Applicable to all Employees.
2. Applicable to all Employees, except those Employees employed on the Effective Date. Such Employees
will participate immediately. All other Employees will need to satisfy the requirements listed above.

4. Compensation
Contributions for the Plan Year in which an Employee first becomes a Participant shall be determined based on the Employee’s “Compensation”:

Check one. A. For the entire Plan Year.

B. For the portion of the Plan Year in which the Employee is eligible to participate in the Plan.
[Note: “Compensation” is defined in Article 2.12 of the Basic Plan Document.]

Form continues on next page.

1.866722.106 Page 3 of 6 032970203

5. Discretionary Nonelective Employer Contributions
If A or B is elected below, the Employer may make discretionary Nonelective Employer Contributions on behalf of each Participant in
accordance with the provisions of this Section 5 and the Basic Plan Document.

Check one. A. Allocation of Nonelective Employer Contributions will not be integrated with Social Security. [See Article 4.10
of the Basic Plan Document.]
B. Allocation of Nonelective Employer Contributions will be integrated with Social Security. [See Article 4.11 of
the Basic Plan Document.]
If the Plan will be integrated with Social Security, fill in the blanks below:

1. The Integration Level means the Social Security Taxable Wage Base for the Plan Year, unless the Employer
elects a lesser amount in (a) or (b) below:
a. (may not exceed the Taxable Wage Base).
$

b. of the Taxable Wage Base in effect on the first day of each Plan Year (may not exceed 100%).
%

2. The Excess Contribution Percentage (which may not exceed the Profit Sharing Maximum Disparity Rate
described below) will be:

3. The Profit Sharing Maximum Disparity Rate shall be:

a. Unless an Integration Level other than the Social Security Taxable Wage Base is specified in
Section 5.B.1 above, 5.7%.
b. If a different Integration Level is specified in Section 5.B.1 above, the applicable percentage
determined in accordance with the table below:

If the Integration Level is more than: But not more than: The applicable percentage is:
$0 X* 5.7%
X* 80% of TWB 4.3%
80% of TWB Y** 5.4%
*X = the greater of $10,000 or 20% of the TWB.
**Y = any amount more than 80% of the TWB but less than 100% of the TWB.

6. Normal Retirement Age

A. Unless otherwise elected below, Normal Retirement Age means age 59½.
1. The Employer adopted a Normal Retirement Age of 55 before January 1, 2009. [Note: This election is only
available if the Employer previously adopted age 55 as the Plan’s Normal Retirement Age. If the Plan’s
prior Normal Retirement Age was age 55, the Employer’s ability to increase the Normal Retirement Age
to age 59½ is limited by Article 10.3 of the Basic Plan Document and applicable anti-cutback provisions of
ERISA and the Code.]

Form continues on next page.

1.866722.106 Page 4 of 6 032970204

7. Multiple Qualified Plans
Select A or B below only if the Employer maintains other qualified plans and uses a method of satisfying the 415 limits or the top-heavy
minimum contribution requirements different from the method provided under the Plan.
A. Other Order for Limiting Annual Additions: If the Employer maintains other defined contribution plans,
annual additions to a Participant’s Account shall be limited as provided in Article 12.3 of the Basic Plan
Document to meet the requirements of Code Section 415, unless the Employer elects this Option and
completes the 415 Correction Addendum describing the order in which annual additions shall be limited
among the plans.
B. Other Method to Satisfy Top-Heavy Minimum Contribution Requirement: If the Employer maintains
other qualified plans that are aggregated with the Plan for top-heavy purposes, the minimum contribution
requirement will be met as provided in Article 13.2 of the Basic Plan Document, unless the Employer elects
this Option and completes the 416 Contributions Addendum to the Adoption Agreement describing the way
in which the minimum contribution requirements will be satisfied in the event the Plan is or is treated as a
“top-heavy plan.”

8. Reliance on Opinion Letter

This is a “standardized” pre-approved plan. You may rely on the opinion letter issued by the Internal Revenue Service as evidence that
your Plan is qualified under Section 401 of the Internal Revenue Code except to the extent provided in Section 7.01 of Revenue Procedure
2017-41. You may not rely on the opinion letter in certain other circumstances or with respect to certain qualification requirements, which
are specified in Section 7.03 of Revenue Procedure 2017-41.
If you have ever maintained or later adopt any plan (including a welfare benefit fund as defined in Section 419(e) of the Internal Revenue
Code, which provides post-retirement medical benefits allocated to separate accounts for key employees, as defined in Section 419A(d)(3)
of the Internal Revenue Code or an individual medical account, as defined in Section 415(1)(2) of the Code) in addition to the Plan, you will
not be able to rely on the opinion letter issued by the Internal Revenue Service for the Pre-Approved Plan with respect to the requirements
of Sections 415 and 416 of the Internal Revenue Code. You will not be considered to have maintained another plan merely because you
maintained another defined contribution plan, provided that (i) the other defined contribution plan terminated before the effective date of
the Plan and (ii) no annual additions were credited to the account of any participant under such other plan within a limitation year of the
Plan. If you adopt or maintain multiple plans and you wish to obtain reliance with respect to the requirements of Sections 415 and 416 of
the Internal Revenue Code, you must apply to Employee Plans Determinations of the Internal Revenue Service for a determination letter
with respect to your Plan.
Failure to properly complete the Adoption Agreement and failure to operate the Plan in accordance with the terms of the Plan document
may result in disqualification of the Plan.

9. Provider Information
A. Name of Provider:
FMR LLC
B. Address of Provider:
245 Summer Street
Boston, Massachusetts 02210
800-544-5373
Questions regarding this pre-approved plan document may be directed to the Provider.

Form continues on next page.

1.866722.106 Page 5 of 6 032970205

10. Execution Page
The Employer appoints Fidelity Management Trust Company as Trustee and agrees to the fees set forth in the Retirement Plan Account
Application, as amended from time to time. The Employer hereby directs the Trustee to invest any funds of the Plan that are transmitted
without complete investment instructions in Fidelity Government Cash Reserves.
The Adoption Agreement may be used only in conjunction with Defined Contribution Retirement Plan, Basic Plan Document No. 04. Failure
to fill out this Adoption Agreement properly may result in the disqualification of the Plan. The Provider shall inform the adopting Employer
of any amendments made to the Plan or of the discontinuance or abandonment of the Pre-Approved Plan.
IN WITNESS WHEREOF, the Employer has caused this Adoption Agreement to be executed
This day of

EMPLOYER (NAME OF BUSINESS)

PRINT NAME OF PERSON SIGNING BELOW

SIGNATURE OF EMPLOYER

X
SIGN

DATE MM/DD/YYYY

X
D AT E

Did you sign the form and include any necessary documents? Regular mail Overnight mail
Send the ENTIRE form and any account application(s) to Fidelity Investments Fidelity Investments
Fidelity Investments. PO Box 770001 100 Crosby Parkway KC1K
Cincinnati, OH 45277-0036 Covington, KY 41015
Questions? Go to Fidelity.com/se401k or call 800-544-5373.

On this form, “Fidelity” means Fidelity Brokerage Services LLC and its affiliates. Brokerage services are
provided by Fidelity Brokerage Services LLC, Member NYSE, SIPC. 493049.7.0 (03/21)

1.866722.106 Page 6 of 6 032970206

 Print Reset Save

Questions? Call 800-544-5373.

The Defined Contribution Retirement Plan —

Trust Agreement
This Trust Agreement (“Trust Agreement”) for the Plan shall be effective as of the last date executed by the Parties and is made between

(“the Employer”) and Fidelity Management Trust Company (“the Trustee”)

Employer

to establish terms for the trust for the associated Plan.

RECITALS 2. Establishment of Trust. The Trustee shall accept and hold in the Trust
1. The Employer stated the terms of the Plan by executing an Adoption such contributions by or on behalf of Participants as it may receive
Agreement to a pre-approved defined contribution plan document from time to time from the Employer together with the earnings
(created under procedures established by the U.S. Internal Revenue thereon, and shall open and maintain records of contributions to and
Service (“IRS”) and for which an affiliate of the Trustee is the pre- withdrawals from the Accounts for such individuals as the Employer
approved plan provider) (a “Fidelity Pre-Approved Document”). shall from time to time certify as Participants in the Plan.
2. A Plan using a Fidelity Pre-Approved Document states the Plan’s terms 3. Exclusive Benefit and Return of Employer Contributions. In
through an Adoption Agreement and a Basic Plan Document plus any accordance with Code Section 401(a)(2) and ERISA Section 403(c)
additional amendments (the “Non-Trust Plan Documents”). (if applicable), the Trustee shall hold the assets of the Trust for
the exclusive purpose of providing benefits to Participants and
3. The Plan must have a trust to hold Plan assets (“Trust Fund”) in order to Beneficiaries and defraying the reasonable expenses of administering
remain qualified under Internal Revenue Code (“Code”) Section 401. the Plan, and no such assets shall ever revert to the Employer except
4. In order to remain qualified under the Code, the Employer executes that if the Employer or the Plan Administrator so direct:
this document to evidence the terms of the Plan’s trust and to appoint (a) contributions made by the Employer by mistake of fact may be
the Trustee for the Plan’s trust. returned to the Employer within one year of the date of payment,
DEFINITIONS (b) contributions that are conditioned on the deductibility thereof
under Code Section 404 may be returned to the Employer within
For the purpose of this Trust Agreement, the definitions set forth in the
one year of the disallowance of the deduction, and
Basic Plan Document shall apply to the respective capitalized terms:
(c) contributions that are conditioned on the initial qualification of
“Account” or “Accounts” shall be defined as in Article 2.1 of the BPD
the Plan under the Code may be returned to the Employer within
“Adoption Agreement” shall be defined as in Article 2.2 of the BPD one year after such qualification is denied by determination
“Basic Plan Document” (BPD) shall be defined as in Article 2.6 of the BPD of the Internal Revenue Service, but only if an application for
determination of such qualification is made within the time
“Beneficiary” shall be defined as in Article 2.7 of the BPD
prescribed by law for filing the Employer’s federal income tax return
“Employer” shall be defined as in Article 2.22 of the BPD for its taxable year in which the Plan is adopted, or such later date
“ERISA” shall be defined as in Article 2.23 of the BPD as the Secretary of the Treasury may prescribe.
“Participants” shall be defined as in Article 2.31 of the BPD All contributions under the Plan are hereby expressly conditioned on
the initial qualification of the Plan and their deductibility under the
“Permissible Investments” shall be defined as “Investments” in Article
Code.
6.2(a)-(d) of the BPD
4. Reports of the Trustee and the Employer. Not later than 120 days
“Plan” shall be defined as in Article 2.32 of the BPD
after the close of each Plan Year where the Plan Year is the calendar
“Plan Administrator” shall be defined as in Article 2.33 of the BPD year (or after the Trustee’s resignation or removal pursuant to Article
“Plan Year” shall be defined as in Article 2.34 of the BPD 10.6 of the BPD), the Trustee shall furnish to the Employer a written
report containing such information as shall be reasonably necessary to
“Pre-Approved Plan” shall be defined as in Article 2.35 of the BPD
complete reports and disclosures required of the Employer pursuant
“Provider” shall be defined as in Article 2.37 of the BPD to ERISA, including, without limitation, records of the transactions
“Trustee” shall be defined as in Article 2.48 of the BPD performed in connection with the Plan during the period in question,
and either a statement of the fair market value of the assets of each
“Trust” shall be defined as in Article 2.46 of the BPD
Participant’s Account as of the end of the period, or information
NOW, THEREFORE, the Employer and the Trustee agree as follows: adequate to permit the Employer to compare such value. Upon the
expiration of 60 days following the date on which such a report is
1. Appointment and Acceptance of Trust Responsibilities. By executing furnished to the Employer, the Trustee shall be forever released and
this Trust Agreement, the Employer establishes a trust with the Trustee discharged from all liability and accountability to anyone with respect
to hold the assets of the Plan, held at Fidelity Brokerage Services LLC to its acts, transactions, duties, obligations, or responsibilities as
(“FBS LLC”), that are invested in Permissible Investments. By executing shown in or reflected by such report, except with respect to any such
this Trust Agreement, the Trustee agrees to accept the rights, duties, acts or transactions as to which the Employer shall have filed written
and responsibilities set forth in this Trust Agreement. The Trustee shall objections within such 60-day period or as otherwise required by law.
have no liability for, and no duty to inquire into, the administration
of the assets of the Plan for periods prior to the date such assets are The Employer shall be responsible for the preparation and filing of
transferred to the Trustee in its role as trustee for the Plan, or assets such reports and disclosures as may be required by ERISA, and for
held outside of this Trust. providing notice to interested parties as required by Code Section
7476. The Employer shall also prepare any return or report required

Form continues on next page.

1.9900475.102 Page 1 of 4 040790101

 as a result of liability incurred by the Plan for tax on unrelated (i) to hold securities unregistered, or to register them in its own name
business taxable income, or windfall profits tax, or any return or report or in the name of nominees in accordance with the provisions of
necessary to preserve the availability of any credit or deduction with Section 2550.403a-1(b) of Department of Labor Regulations;
respect thereto. (j) to appoint custodians to hold investments within the jurisdiction of
5. Fees and Expenses of the Trust. The Trustee shall be entitled to the the district courts of the United States and to deposit securities with
fees set forth in the materials provided to Participants by the Trustee, stock clearing corporations or depositories or similar organizations;
as amended from time to time, and to reimbursement of all reasonable (k) to make, execute, acknowledge, and deliver any and all
expenses incurred in the performance of its duties. If the Employer instruments that it deems necessary or appropriate to carry out the
fails to pay agreed compensation or to reimburse expenses, the same powers herein granted;
shall be paid from the assets of the Trust. To the extent incurred by the
Trustee, any income, gift, estate, and inheritance taxes and other taxes (l) generally to exercise any of the powers of an owner with respect
of any kind whatsoever (including transfer taxes incurred in connection to all or any part of the Trust Fund; and
with the investment or reinvestment of the assets of the Trust) that may (m) to take all such actions as may be necessary under the Trust
be levied or assessed in respect of such assets, if allocable to specific Agreement, to the extent consistent with applicable law and
Participants, shall be charged to their Accounts, and if not so allocable the BPD.
shall be charged proportionately to all Participants’ Accounts. All other The Employer specifically acknowledges and authorizes that affiliates
administrative expenses incurred by the Trustee in the performance of or subsidiaries of the Trustee may act as its agent in the performance of
its duties, including fees for legal services rendered to the Trustee, shall ministerial, nonfiduciary duties under the Trust.
be charged proportionately to all Accounts. All such fees and taxes
and other administrative expenses charged to a Participant’s Account Unless specifically agreed to otherwise in writing by the Trustee, the
shall be collected from the amount of any contribution or distribution Trustee shall have no discretion, responsibility, or authority with respect
to be credited to such Account, or by selling assets credited to such to the following items: (1) investment of the Trust Fund; (2) selection
Account, and the Trustee is expressly authorized in the Retirement of Permissible Investments (the Trustee shall not render investment
Brokerage Customer Agreement, the brokerage account agreement advice to any person in connection with the selection of Permissible
terms and conditions, to liquidate any assets held in a Participant’s Investments); (3) determination of the correctness of the amounts
Account for the purpose of paying such amounts. The Trustee shall not contributed and remitted to the Trustee or determination of whether
be deemed to be exercising discretion by causing the sale of any such any contribution is payable under the Plan; or (4) responsibility for the
assets to pay such fees or expenses. The Employer shall be responsible collection of any contributions to the Plan. With respect to collection
for payment of any deficiency. of any contributions to the Plan, the Administrator shall be the named
fiduciary responsible for ensuring the Employer or participants, where
6. Power of Trustee. The Trustee shall act solely as directed trustee of relevant, remit contributions repayments to the Trust and shall have
the assets it holds for the Plan (“Trust Fund”). In addition to and not in the duty and responsibility for the collection of such contributions
limitation of such powers as the Trustee has by law or under any other when not timely made. The Trustee shall be authorized to provide
provisions of the Plan, the Trustee shall have the following powers, information and records regarding contributions it has received to the
each of which the Trustee exercises solely as a directed trustee in Administrator or other named fiduciary and may accept contributions
accordance with the written direction of the Employer except to the and/or carry out related allocation instructions from, such named
extent a Plan asset is subject to Participant direction of investment fiduciary upon its request, as may be further described in the BPD.
and provided that no such power shall be exercised in any manner
inconsistent with the provisions of ERISA: 7. Limitation of Duties and Liabilities. The Trustee shall not be
responsible in any way for the purpose or propriety of any distribution
(a) to deal with all or any part of the Trust Fund and to invest all or a made pursuant to Article 7 of the BPD, or any other action or
part of the Trust Fund in Permissible Investments, without regard to nonaction taken pursuant to the request of the Employer, the Plan
the law of any state regarding proper investment; Administrator, a Participant, or a Beneficiary; the validity or effect of
(b) to retain uninvested such cash as the Administrator, named the Plan and Trust Agreement; the qualification of the Plan or the
fiduciary, or Plan Participant under the Plan may, from time to Trust under the Code and ERISA; or the examination of the Plan by
time, direct; the Internal Revenue Service or the Department of Labor. Except as
(c) to sell, lease, convert, redeem, exchange, or otherwise dispose of provided in Article 4.14 of the BPD, the Trustee shall have no authority
all or any part of the assets constituting the Trust Fund; to inquire into the correctness of any amounts contributed and
remitted to the Trustee or to determine whether any contribution is
(d) to enforce by suit or otherwise, or to waive, its rights on behalf payable under Article 4 of the BPD.
of the Trust, and to defend claims asserted against it or the Trust,
provided that the Trustee is indemnified to its satisfaction against The Employer and the executor, administrator, or successor of the
liability and expenses including claims for delinquent contributions Employer, as appropriate, shall at all times fully indemnify and save
for which the Administrator, pursuant to its duties under Article 4.14 harmless the Trustee, and its successors and assigns from any liability
of the BPD, has directed in writing the Trustee to pursue ); arising from any actions taken or not taken per direction from the
Employer, Plan Administrator, Participant or Beneficiary, and from any
(e) to employ legal, accounting, clerical, and other assistance and all liability whatsoever, which may arise in connection with the Plan,
to carry out the provisions of this Trust Agreement and to except liability arising from the gross negligence or willful misconduct
pay the reasonable expenses of such employment, including of the Trustee.
compensation, from the Trust if not paid by the Employer;
The Trustee shall not be under any duty to take any action other than
(f) to compromise, adjust, and settle any and all claims against or in as herein specified with respect to the Trust, unless the Employer
favor of it or the Trust; shall furnish the Trustee with instructions in proper form and such
(g) to oppose, or participate in and consent to the reorganization, instructions shall have been specifically agreed to by the Trustee,
merger, consolidation, or readjustment of the finances of any or to defend or engage in any suit with respect to the Trust unless
enterprise, to pay assessments and expenses in connection the Trustee shall have first agreed to do so and shall have been fully
therewith, and to deposit securities under deposit agreements; indemnified to its satisfaction.
(h) to apply for or purchase annuity contracts in accordance with The Trustee and its agents may conclusively rely upon and shall be
Article 14 of the BPD; protected in acting upon any written order from the Employer, Plan
Administrator, Participant, or Beneficiary or its delegate or any other
notice, request, consent, certificate or other instrument or paper

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1.9900475.102 Page 2 of 4 040790102

 believed by it to be genuine and to have been properly executed, Trustee or successor trustee, or through reorganization, consolidation,
and, so long as it acts in good faith, in taking or omitting to take or merger, or any similar transaction of either the Trustee or successor
any other action. The Trustee may delegate to one or more entities trustee, shall, upon consummation of the transaction, become the
the performance of recordkeeping and other ministerial services in successor trustee under this Trust Agreement.
connection with the Plan, for a reasonable fee to be borne by the 9. Interpretation and Construction. In the event of any conflict
Trustee and not by the Plan or the Trust. Any such agent’s duties and between the terms of the BPD and Adoption Agreement and any
responsibilities shall be confined solely to the performance of such provision contained in this Trust Agreement, the terms of the BPD
services and shall continue only for so long as the Trustee named and Adoption Agreement will govern.
in the Adoption Agreement serves as Trustee. The Trustee shall not
have any liability with respect to money transferred to an insurance 10. Indemnification. The Employer shall indemnify the Trustee with
company pursuant to the Plan. respect to any third-party claims or regulatory proceedings asserted
or commenced against the Trustee to the extent such claim or
The Trustee shall be fully protected in acting upon the directions of proceeding is the result of any act done, or an act failed to be
the Plan Administrator in making benefit distributions, and shall have done, by any individual or person with respect to the Plan or the
no duty to determine the rights or benefits of any person under the Trust, excepting only those Losses asserted as part of such claim
Plan or to inquire into the right or power of the Plan Administrator to or proceeding that result from the Trustee’s negligence or willful
direct any such distribution. A beneficiary designation form completed misconduct under, or breach of the terms of, this Trust Agreement.
and filed in accordance with Article 7.4 of the BPD shall be deemed The Trustee shall indemnify the Employer with respect to any third-
a direction of the Plan Administrator for purposes of this Section. The party claims or regulatory proceedings asserted or commenced
Trustee shall be entitled to assume conclusively that any determination against the Employer to the extent Losses asserted as part of any
by the Plan Administrator with respect to a distribution meets the such claim or proceeding result from the Trustee’s negligence
requirements of the Plan. The Trustee shall not be required to make or willful misconduct under, or breach of the terms of, this Trust
any payment hereunder in excess of the net realizable value of the Agreement. Any reference to the Employer or the Trustee as an
assets of the Trust held for the Participant at the time of such payment, indemnified Party shall be deemed to include their respective
nor to make any payment in cash unless the Plan Administrator has directors, officers, affiliates, and subsidiaries. “Losses” shall mean
furnished instructions in a form and manner acceptable to the Trustee and include any and all liability, loss, damage, claim, expense, cost,
as to the assets to be converted to cash for the purposes of making fine, fee, penalty, obligation, or injury including those resulting from
payment. The Trustee is expressly authorized to liquidate any assets any and all actions, suits, proceedings, demands, assessments,
held in a Participant’s Account to make a payment under this Section or judgments, together with reasonable costs and expenses
but shall not be deemed to have exercised any fiduciary discretion in including the attorneys’ fees and other legal costs and expenses
doing so. relating thereto.
8. Substitution, Resignation, or Removal of Trustee. The Provider 11. Consultation by the Trustee with Counsel. The Trustee may consult
may at any time appoint an institution as a substitute for the Trustee with legal counsel (who may be but need not be counsel for the
named in the Adoption Agreement that is a bank or is a nonbank Employer or the Administrator) concerning any question which may
trustee that has received approval from the Internal Revenue Service; arise with respect to its rights and duties under the Plan and Trust,
provided that the Provider shall notify the Employer in writing at least and the opinion of such counsel shall, to the extent permitted by
30 days in advance of the effective date of any such appointment. The law, be full and complete protection in respect of any action taken
Trustee may resign at any time upon 30 days’ notice in writing to the or omitted by the Trustee hereunder in good faith and in accordance
Employer and may be removed by the Employer at any time upon 30 with the opinion of such counsel.
days’ notice in writing to the Trustee. Upon resignation of the Trustee,
the Provider may propose a successor trustee. Upon resignation by or 12. Persons Dealing with the Trustee. No person dealing with the
removal of the Trustee, the Employer shall no longer participate in the Trustee shall be bound to see to the application of any money
Fidelity Pre-Approved Plan created by the Non-Trust Plan Documents or property paid or delivered to the Trustee or to inquire into the
and shall be deemed to have adopted an individually designed plan. validity or propriety of any transactions.
In such event, the Employer shall appoint a successor trustee within 13. Fiscal Year of the Trust. The fiscal year of the Trust shall coincide
60-day period and the Trustee shall transfer the assets of the Trust with the Plan Year.
to the successor trustee upon receipt of sufficient evidence (such as 14. Amendment. In accordance with provisions of the Plan, and subject
a determination letter or opinion letter from the Internal Revenue to the limitations set forth therein, this Trust Agreement may be
Service or an opinion of counsel satisfactory to the Trustee) that amended by the Employer and the Trustee executing an amendment
such trust shall be a qualified trust under the Code. Upon receipt in writing signed by the parties. No amendment to this Trust
by the Trustee of written acceptance of appointment by a substitute Agreement shall divert any part of the Trust Fund to any purpose
or successor trustee, the Trustee shall transfer and pay over to such other than as provided in Section 3.
successor the assets of the Trust. The Trustee is authorized, however,
to reserve such sum of money or property as it may deem advisable 15. Procedure upon Termination of Trust. As soon as administratively
for payment of all its fees, compensation, costs and expenses, or for feasible after the stated date that the Plan terminates pursuant to
payment of any other liabilities constituting a charge on or against Article 10.6 of the BPD, the Trustee shall, after paying all expenses
the assets of the Trust or on or against the Trustee, with any balance of the Trust, allocating any unallocated assets of the Trust, and
of such reserve remaining after the payment of all such items to be adjusting all Accounts to reflect such expenses and allocations,
paid over to the substitute or successor trustee. The Trustee and the distribute to Participants, former Participants, and Beneficiaries the
Provider shall not be liable for the acts or omissions of any substitute assets credited to their Accounts in accordance with the instructions
or successor trustee. If within 90 days after the Trustee’s resignation or of the Plan Administrator or the Employer; provided, however, that
removal a successor Trustee has not been appointed, the Trustee shall the Trustee shall not be required to make any such distribution until
terminate the Trust pursuant to Article 10.6 of the BPD. The Trustee it has received notice of any determination by the Internal Revenue
named in the Adoption Agreement has accepted its appointment, Service, which the Trustee may reasonably require. Each such
and intends to serve, only for so long as the Employer’s plan is a distribution shall be made promptly in accordance with Article 7 of
Pre-Approved Plan. If the Plan is no longer a Pre-Approved Plan, the the BPD. Upon completion of such distribution, the Trustee shall be
Trustee shall resign in accordance with this Section. Notwithstanding relieved from all further liability with respect to all amounts so paid.
the foregoing, any successor to the Trustee or successor trustee, either
through sale or transfer of the business or trust department of the

Form continues on next page.

1.9900475.102 Page 3 of 4 040790103

16. Missing Plan Participants. If distribution is to be made to a 17. Governing Law. The Trust shall be construed, administered,
Participant or Beneficiary who cannot be located, following the Plan and enforced according to the laws of the Commonwealth of
Administrator’s completion of such search methods as described in Massachusetts to the extent not preempted by the laws of the
applicable Department of Labor guidance, the Administrator shall United States of America (including ERISA); any provision of the
give instructions to the Trustee to roll over the distribution to an Trust in conflict with applicable federal law shall survive to the extent
individual retirement account established by the Administrator in permitted by that law. References to ERISA or to DOL Regulations or
the name of the missing Participant or Beneficiary, which account other guidance under ERISA shall apply only to the extent that the
shall satisfy the requirements of the Department of Labor automatic Trust is subject to ERISA and is not excluded from coverage under
rollover safe harbor generally applicable to amounts less than or ERISA pursuant to DOL Regulation Section 2510.3-3(b) or otherwise.
equal to the maximum cash out amount specified in Code Section
401(a)(31)(B)(ii) ($5,000 as of January 1, 2018) that are mandatorily
distributed from the Plan. In the alternative, the Employer may
direct the Trustee, subject to applicable guidance, to transfer the
Account of any such missing Participant or Beneficiary, regardless of
the amount of any such Account to the Pension Benefit Guarantee
Corporation. In the absence of such instructions, the Trustee shall
make no distribution to the distributee.

IN WITNESS WHEREOF, each of the Parties hereto has caused this Trust Agreement to be executed by its duly authorized representative.
Trustee Signature

PRINT TRUSTEE NAME

Clint Brandner
PRINT TRUSTEE TITLE

VP, Operations
TRUSTEE SIGNATURE

X
SIGN

Employer Signature and Date

EMPLOYER (PLAN SPONSOR)

PRINT NAME OF PERSON SIGNING BELOW

PRINT TITLE

EMPLOYER SIGNATURE TODAY’S DATE MM/DD/YYYY

X X
SI GN

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1.9900475.102 Page 4 of 4 040790104