UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF NEW YORK

Case No.: 07-CV-3592

DECLARATION OF DARRICK E.

ANTELL,M.D.,DDS

BARBARA ROCKMORE,

Plaintiff,

-againstDARRICK E. ANTELL,

DARRICK E. ANTELL, M.D., D.D.S., P.C.,

DARRICK E. ANTELL, M.D., F.A.C.S and

DARRICK E. ANTELL, M.D., F.A.C.S., P.C.,

Defendants.

I, Darrick E. Antell, M.D., DDS, hereby declare and state under penalty of perjury:

1. Plaintiff Barbara Rockmore, in her Amended Complaint, has lodged a variety

of repugnant and frankly defamatory statements concerning my conduct

While I vociferously deny those allegations, at this time I submit this

Declaration simply to provide information concerning the validity of the

Release that Ms. Rockmore executed, in support of Defendants1 Motion to

Dismiss.

2. In connection with a government tax investigation into the corporation,

Darrick E. Antell, MD, DDS, PC, I agreed to pay any counsel fees that Ms,

Rocfcroore might incur in connection with that investigation. In this regard,

and at issue in this matter, I received an invoice for legal services provided by

Ms. Rockmore's chosen counsel, the law firm of Arkin Kaplan. This invoice

was for $3,066.25, and was paid by check dated July 22, 2004. Ms.

Rockmore, as my office manager, cut this check and entered it into our

accounts payable system. While Ms. Rockmore speculates that I must have

"embargoed" the check for this payment based on the fact that the Arkin

Case 1:07-cv-03592-DAB Document 19 Filed 07/17/2007 Page 1 of 9
Kaplan law firm did not deposit this check until Monday, August 2,2004, this

speculation has no factual hasis. My understanding is that this check was sent

out, along with 20 other checks that were cut that day, on July 22,2004. I do

not know why Arkin Kaplan did not deposit this check until August 2Dd, but I

did not place a hold on this check, as Ms. Rockmore asserts.

3. At the time of Ms. Rockmore's resignation, she was a participant in my

office's 401(k) and Profit Sharing plan (the "Plan"). While Ms. Rockmore

asserts that I administered this Plan, in fact all administration was handled by

Pension Innovations, a third-party administrator. Within weeks of Ms.

Rockmore's resignation, notice of her intent to roll over all of her pension

funds was received. These funds were rolled over to another account on

August 17, 2004, at which point her Plan account was closed, as she no longer

had any retirement funds invested in the Plan. A copy of Ms. Rockmore's

rollover request, dated August 3, 2004, concerning is annexed hereto, as well

as the statement demonstrating this rollover.

I declare under penalty of perjury under the laws of the United States of America

that the foregoing is true and correct.

Executed this 17th day of June, 2007, in New York, New York.

«•«•

Darrick E. Antell, MD, DDS

Case 1:07-cv-03592-DAB Document 19 Filed 07/17/2007 Page 2 of 9
Darrick E. Antell, M.D., D.D.S., P.C. Profit Sharing Plan

Participant Distribution Election Form

Name: Barbara Rockmote __^_______ Social Security* _____

Address: <£flft (jj.'l^ S~T. 'SK

=

 2*-£ Date of Birth: 02/18/1951

City: fl)^0JjJ Cyfl"Y~/^- State /(J V Zip; > <9 ^^ V^ Date of Separation: 07/29/2004

Due to your separation, you quality lor a benefit distribution from your retirement plan. You may elect to receive your retirement benefit in

one of the formi detailed below. Please (elect o*fy one option below.

I I Lump Sum Distribution

A single payment equivalent to your vested accrued benefit earned to date of separation. A single sum cash

settlement discharges all plan obligations to you. The exact single sum payable to you win depend on the exact

surrender value of your account as of (he date surrendered, and may vary from that below due to market

fluctuation and any applicable surrender fees. The approximate single sum total available to you equals $ 37,999.49

Rollover to an Individual Retirement Account (IRA) or other Qualified Plan:

A single payment equivalent to your vested accrued benefit earned to date directly transferred to another

qualified plan or Individual Retirement Account (IRA). The approximate value of the rollover equals the

value indicated above in the Lump Sum Distribution Option. If you aabcl tfab option yon must complete the

Information below with respect to the reeehring qualified plaa or IRA account:

Plan Name (If IRA, put IRA'): nOUovK'/' TT*fgp\

Three Digit Plan Number (N/A if IRA): fV / KV

NaraeofPlMTruiteeorlRACustodian: P| DElt TXi i ro\J6"STMfrMS

Mailing Address: '5>Sp fVrl ^C rAv^t-vi*^

^\)^L .NJU IQO£."ZAccount Number _

Plan or IRA Contact Person:

Contact's Telephone Number: 3-O--^1-l ~ 2-'*>Z'3-

Additional Information:

| | Deferred Benefit

You may elect to maintain your balance in the plan until the later of your Normal Retirement Date or ags 62.

Your account will be adjusted to reflect investment performance. At your subsequent direction, your account

will be distributed under one of the options outlined above based upon the account value at that time.

Case 1:07-cv-03592-DAB Document 19 Filed 07/17/2007 Page 3 of 9
I have rc*d the above informatiM aid elect to receive my benefit payable in the form elected above. I certify that I

have received the enclosed Special Tn Notice Regarding Plan Payments. I aUo understand that I have the right to

erailder the decUloa of whether or not to elect a direct rollover for at least 30 day* after receipt of tab notice.

EXECUTED thi* 3*^- M OUJ&^AX-. pasM.

6 *~

&JkAjta $£&Ltourti. &4

S&unalrirtcipt* §1 StftanttrkfUaUfntaatMttfraae

^Sj^ol tf-Ad&Afo

Prittd NlM oTNaUfjr Pnbfc

Stateof Mm; l^fc.

^^ryPublfc,St»^nIivu|k County of /tO^^WpfdL

, QuilM^gS^;^ MyCo^^onExp^ ^ll ^

Commlttlon to^^JZ/Q-j

i<»^y

CONSENT OF SPOUSE

I, the undersigned, being the spouse of the plan participant whose signature appears above, do hereby consent to the

foregoing distribution election. I undentand and acknowledge that as a result of this consent, I will not receive any benefits

payable under ihe plan except to the extent specifically provided for above.

EXECUTED this day of

SfeoumorspMM SitMtOToTPluAdnifainratofOTNottiyPiiblic

Pitattd MOM of Notify Pvbhc

Stateof

County of

My Commission Expires

I certify to the best of my knowledge that the above participmt is not married or considered to be married under any common

law agreement.

S«*»norPkaIUrnMdUM

Please return this form to:

Pension Innovations ft Consulting, LLC

Attn: Chris Koby

2254 Centennial Road

Toledo, OH 43617

Case 1:07-cv-03592-DAB Document 19 Filed 07/17/2007 Page 4 of 9
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