Oak Grove Senior Living, L.L.C.

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2008-05-01
Business code	623000
Sponsor’s telephone number	6012969711
Plan sponsor’s address	2 COURTLAND DR, HATTIESBURG, MS, 394028542

Signature of

Role	Plan administrator
Date	2014-07-21
Name of individual signing	KATHY MCPHAIL
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2014-07-21
Name of individual signing	KATHY MCPHAIL
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2008-05-01
Business code	623000
Sponsor’s telephone number	6012969711
Plan sponsor’s address	2 COURTLAND DR, HATTIESBURG, MS, 394028542

Signature of

Role	Plan administrator
Date	2014-03-26
Name of individual signing	KATHY MCPHAIL
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2014-03-26
Name of individual signing	KATHY MCPHAIL
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2008-05-01
Business code	623000
Sponsor’s telephone number	6012969711
Plan sponsor’s address	2 COURTLAND DR, HATTIESBURG, MS, 394028542

Signature of

Role	Plan administrator
Date	2013-02-07
Name of individual signing	KATHY MCPHAIL
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2013-02-07
Name of individual signing	KATHY MCPHAIL
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2008-05-01
Business code	623000
Sponsor’s telephone number	6012969711
Plan sponsor’s address	2 COURTLAND DR, HATTIESBURG, MS, 394028542

Plan administrator’s name and address

Administrator’s EIN	161679749
Plan administrator’s name	OAK GROVE SENIOR LIVING LLC
Plan administrator’s address	2 COURTLAND DR, HATTIESBURG, MS, 394028542
Administrator’s telephone number	6012969711

Signature of

Role	Plan administrator
Date	2012-01-30
Name of individual signing	KATHY MCPHAIL
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2012-01-30
Name of individual signing	KATHY MCPHAIL
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2008-05-01
Business code	623000
Sponsor’s telephone number	6012969711
Plan sponsor’s address	2 COURTLAND DR, HATTIESBURG, MS, 394028542

Plan administrator’s name and address

Administrator’s EIN	161679749
Plan administrator’s name	OAK GROVE SENIOR LIVING LLC
Plan administrator’s address	2 COURTLAND DR, HATTIESBURG, MS, 394028542
Administrator’s telephone number	6012969711

Signature of

Role	Plan administrator
Date	2011-02-23
Name of individual signing	KATHY MCPHAIL
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2011-02-23
Name of individual signing	KATHY MCPHAIL
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2008-05-01
Business code	623000
Sponsor’s telephone number	6012969711
Plan sponsor’s address	2 COURTLAND DR, HATTIESBURG, MS, 394028542

Plan administrator’s name and address

Administrator’s EIN	161679749
Plan administrator’s name	OAK GROVE SENIOR LIVING LLC
Plan administrator’s address	2 COURTLAND DR, HATTIESBURG, MS, 394028542
Administrator’s telephone number	6012969711

Signature of

Role	Plan administrator
Date	2010-05-20
Name of individual signing	KATHY MCPHAIL
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2010-05-20
Name of individual signing	KATHY MCPHAIL
Valid signature	Filed with authorized/valid electronic signature

Loan Status Date	2022-05-13
Loan Status	Paid in Full
Loan Maturity in Months	60
SBA Guaranty Percentage	100
Loan Approval Amount (at origination)	175597
Loan Approval Amount (current)	175597
Undisbursed Amount	0
Franchise Name	-
Lender Location ID	120708
Servicing Lender Name	The First Bank
Servicing Lender Address	6480 Hwy 98, West, HATTIESBURG, MS, 39402
Rural or Urban Indicator	R
Hubzone	N
LMI	N
Business Age Description	Existing or more than 2 years old
Project Address	Hattiesburg, LAMAR, MS, 39402-8299
Project Congressional District	MS-04
Number of Employees	28
NAICS code	531110
Borrower Race	Unanswered
Borrower Ethnicity	Unknown/NotStated
Business Type	Partnership
Originating Lender ID	120708
Originating Lender Name	The First Bank
Originating Lender Address	HATTIESBURG, MS
Gender	Unanswered
Veteran	Unanswered
Forgiveness Amount	168147.76
Forgiveness Paid Date	2022-04-04