Document:

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                                                                     EXHIBIT 4.3

                                 AMENDMENT NO. 2
                                     TO THE
                    TLC VISION (USA) CORPORATION 401(k) PLAN
                AS AMENDED AND RESTATED JANUARY 1, 2004 ("PLAN")

      Pursuant to Section 10.01 of the TLC Vision (USA) Corporation 401(k), as
amended and restated as of January 1, 2004 ("Plan"), TLC Vision (USA)
Corporation hereby adopts this Amendment to the Plan to comply with final and
temporary regulations under Internal Revenue Code ("Code") Section 401(a)(9)
pursuant to the procedures set forth in Rev. Proc. 2002-29.

ARTICLE I. MINIMUM DISTRIBUTION REQUIREMENTS.

SECTION 1. GENERAL RULES

      1.1   EFFECTIVE DATE. The provisions of this article will apply for
purposes of determining required minimum distributions for calendar years
beginning with the 2003 calendar year,

      (check box if earlier effective date is applicable and insert date) o as
      well as required minimum distributions for the 2002 calendar year that are
      made on or after __________________, 2002.

      1.2   COORDINATION WITH MINIMUM DISTRIBUTION REQUIREMENTS PREVIOUSLY IN
EFFECT. If the box in section 1.1 above is checked, such that an effective date
earlier than the 2003 calendar year is specified, then required minimum
distributions for 2002 under this article will be determined as follows:

            (a) If the total amount of 2002 required minimum distributions under
            the Plan made to the distributee prior to the effective date of this
            article equals or exceeds the required minimum distributions
            determined under this article, then no additional distributions will
            be required to be made for 2002 on or after such date to the
            distributee.

            (b) If the total amount of 2002 required minimum distributions under
            the plan made to the distributee prior to the effective date of this
            article is less than the amount determined under this article, then
            required minimum distributions for 2002 on and after such date will
            be determined so that the total amount of required minimum
            distributions for 2002 made to the distributee will be the amount
            determined under this article.

      1.3   PRECEDENCE. The requirements of this article will take precedence
over any inconsistent provisions of the Plan.

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      1.4   REQUIREMENTS OF TREASURY REGULATIONS INCORPORATED. All distributions
required under this article will be determined and made in accordance with the
Treasury regulations under section 401(a)(9) of the Internal Revenue Code.

SECTION 2. TIME AND MANNER OF DISTRIBUTION.

      2.1   REQUIRED BEGINNING DATE. The Participant's entire interest will be
distributed, or begin to be distributed, to the Participant no later than the
Participant's required beginning date.

      2.2   DEATH OF PARTICIPANT BEFORE DISTRIBUTIONS BEGIN. If the Participant
dies before the distributions begin, the Participant's entire interest will be
distributed, or begin to be distributed, no later than as follows:

            (a) If the Participant's surviving spouse is the Participant's sole
      designated beneficiary, then, except as provided in Section 5,
      distributions to the surviving spouse will begin by December 31 of the
      calendar year immediately following the calendar year in which the
      Participant died, or by December 31 of the calendar year in which the
      Participant would have attained age 70-1/2, if later.

            (b) If the Participant's surviving spouse is not the Participant's
      sole designated beneficiary, then, except as provided in Section 5,
      distributions to the designated beneficiary will begin by December 31 of
      the calendar year immediately following the calendar year in which the
      Participant died.

            (c) If there is no designated beneficiary as of September 30 of the
      year following the year of the Participant's death, the participant's
      entire interest will be distributed by December 31 of the calendar year
      containing the fifth anniversary of the Participant's death.

            (d) If the Participant's surviving spouse is the Participant's sole
      designated beneficiary and the surviving spouse dies after the Participant
      but before distributions to the surviving spouse begin, this section 2.2,
      other than section 2.2(a), will apply as if the surviving spouse were the
      Participant.

For purposes of this section 2.2 and section 4, unless section 2.2(d) applies,
distributions are considered to begin on the Participant's required beginning
date. If section 2.2(d) applies, distributions are considered to begin on the
date distributions are required to begin to the surviving spouse under section
2.2(a). If distributions under an annuity purchased from an insurance company
irrevocably commence to the Participant before the Participant's' required
beginning date (or to the Participant's surviving spouse before the date
distributions are required to begin to the surviving spouse under section
2.2(a)), the date distributions are considered to begin is the date
distributions actually commence.

      2.3   FORMS OF DISTRIBUTION. Unless the Participant's interest is
distributed in the form of an annuity purchased from an insurance company or in
a single sum on or before the required beginning date, as of the first
distribution calendar year distributions will be made in accordance

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with sections 3 and 4 of this article. If the Participant's interest is
distributed in the form of an annuity purchased from an insurance company,
distributions thereunder will be made in accordance with the requirements of
section 401(a)(9) of the Code and the Treasury Regulations.

SECTION 3. REQUIRED MINIMUM DISTRIBUTIONS DURING PARTICIPANT'S LIFETIME.

      3.1   AMOUNT OF REQUIRED MINIMUM DISTRIBUTION FOR EACH DISTRIBUTION
CALENDAR YEAR. During the Participant's lifetime, the minimum amount that will
be distributed for each distribution calendar year is the lesser of:

            (a) the quotient obtained by dividing the Participant's account
      balance by the distribution period in the Uniform Lifetime Table set forth
      in section 1.401(a)(9)-9 of the Treasury regulations, using the
      Participant's age as of the Participant's birthday in the distribution
      calendar year; or

            (b) if the Participant's sole designated beneficiary for the
      distribution calendar year is the Participant's spouse, the quotient
      obtained by dividing the Participant's account balance by the number in
      the Joint and Last Survivor Table set forth in section 1.401(a)(9)-9 of
      the Treasury regulations, using the Participant's and spouse's attained
      ages as of the Participant's and spouse's birthdays in the distribution
      calendar year.

      3.2   LIFETIME REQUIRED MINIMUM DISTRIBUTIONS CONTINUE THROUGH YEAR OF
PARTICIPANT'S DEATH. Required minimum distributions will be determined under
this section 3 beginning with the first distribution calendar year and up to and
including the distribution calendar year that includes the Participant's date of
death.

SECTION 4. REQUIRED MINIMUM DISTRIBUTIONS AFTER PARTICIPANT'S DEATH.

      4.1   DEATH ON OR AFTER DATE DISTRIBUTIONS BEGIN.

            (a) PARTICIPANT SURVIVED BY DESIGNATED BENEFICIARY. If the
      Participant dies on or after the date distributions begin and there is a
      designated beneficiary, the minimum amount that will be distributed for
      each distribution calendar year after the year of the Participant's death
      is the quotient obtained by dividing the Participant's account balance by
      the longer of the remaining life expectancy of the Participant or the
      remaining life expectancy of the Participant's designed beneficiary,
      determined as follows:

                  (1) The Participant's remaining life expectancy is calculated
      using the age of the participant in the year of death, reduced by one for
      each subsequent year.

                  (2) If the Participant's surviving spouse is the Participant's
      sole designated beneficiary, the remaining life expectancy of the
      surviving spouse is calculated for each distribution calendar year after
      the year of the Participant's death using the surviving spouse's age as of
      the spouse's birthday in that year. For distribution calendar years after
      the year of the surviving spouse's death, the remaining life expectancy of
      the surviving

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      spouse is calculated using the date of the surviving spouse as of the
      spouse's birthday in the calendar year of the spouse's death, reduced by
      one for each subsequent calendar year.

                  (3) If the Participant's surviving spouse is not the
      Participant's sole designated beneficiary, the designated beneficiary's
      remaining life expectancy is calculated using the age of the beneficiary
      in the year following the year of the Participant's death, reduced by one
      for each subsequent year.

            (b) NO DESIGNATED BENEFICIARY. If the Participant dies on or after
      the date distributions begin and there is no designated beneficiary as of
      September 30 of the year after the year of the Participant's death, the
      minimum amount that will be distributed for each distribution calendar
      year after the year of the Participant's death is the quotient obtained by
      dividing the Participant's account balance by the participant's remaining
      life expectancy calculated using the age of the Participant in the year of
      death, reduced by one for each subsequent year.

      4.2   DEATH BEFORE DATE DISTRIBUTIONS BEGIN.

            (a) PARTICIPANT SURVIVED BY DESIGNATED BENEFICIARY. Except as
      provided in Section 5, if the Participant dies before the date
      distributions begin and there is a designated beneficiary, the minimum
      amount that will be distributed for each distribution calendar year after
      the year of the Participant's death is the quotient obtained by dividing
      the Participant's account balance by the remaining life expectancy of the
      Participant's designated beneficiary, determined as provided in section
      4.1.

            (b) NO DESIGNATED BENEFICIARY. If the Participant dies before the
      date distributions begin and there is no designated beneficiary as of
      September 30 of the year following the year of the Participant's death,
      distribution of the participant's entire interest will be completed by
      December 31 of the calendar year containing the fifth anniversary of the
      Participant's death.

            (c) DEATH OF SURVIVING SPOUSE BEFORE DISTRIBUTIONS TO SURVIVING
      SPOUSE ARE REQUIRED TO BEGIN. If the Participant dies before the date
      distributions begin, the Participant's surviving spouse is the
      Participant's sole designated beneficiary, and the surviving spouse dies
      before distributions are required to begin to the surviving spouse under
      section 2.2(a), this section 4.2 will apply as if the surviving spouse
      were the Participant.

SECTION 5. SPECIAL ELECTIONS. This Section is effective on and after January 1,
2004.

      Participants or beneficiaries may elect on an individual basis whether the
5-year rule or the life expectancy rule in Sections 2.2 and 4.2 applies to
distributions after the death of a Participant who has a designated beneficiary.
The election must be made no later than the earlier of September 30 of the
calendar year in which distribution would be required to begin under Section
2.2, or by September 30 of the calendar year which contains the fifth
anniversary of the Participant's (or, if applicable, surviving spouse's) death.
If neither the Participant nor beneficiary

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makes an election under this section 5.1, distributions will be made in
accordance with Sections 2.2 and 4.2.

SECTION 6. DEFINITIONS.

      6.1   DESIGNATED BENEFICIARY. The individual who is designated as the
beneficiary under section 5.03 of the Plan and is the designated beneficiary
under section 401(a)(9) of the Internal Revenue Code and section 1.401(a)(9)-1,
Q&A-4, of the Treasury regulations.

      6.2   DISTRIBUTION CALENDAR YEAR. A calendar year for which a minimum
distribution is required. For distributions beginning before the Participant's
death, the first distribution calendar year is the calendar year immediately
preceding the calendar year which contains the Participant's required beginning
date. For distributions beginning after the Participant's death, the first
distribution calendar year is the calendar year in which distributions are
required to begin under section 2.2. The required minimum distribution for the
Participant's first distribution calendar year will be made on or before the
Participant's required beginning date. The required minimum distribution for
other distribution calendar years, including the required minimum distribution
for the distribution calendar year in which the Participant's required beginning
date occurs, will be made on or before December 31 of that distribution calendar
year.

      6.3   LIFE EXPECTANCY. Life expectancy as computed by use of the Single
Life Table in section 1.401(a)(9)-9 of the Treasury regulations.

      6.4   PARTICIPANT'S ACCOUNT BALANCE. The account balance as of the last
valuation date in the calendar year immediately preceding the distribution
calendar year (valuation calendar year) increased by the amount of any
contributions made and allocated or forfeitures allocated to the account balance
as of dates in the valuation calendar year after the valuation date and
decreased by distributions made in the valuation calendar year after the
valuation date. The account balance for the valuation calendar year includes any
amounts rolled over or transferred to the Plan either in the valuation calendar
year or in the distribution calendar year if distributed or transferred in the
valuation calendar year.

      6.5   REQUIRED BEGINNING DATE. The date specified in section 6.02(d)(3)(A)
of the Plan and referred to therein as the "required distribution date."

ARTICLE II. EXECUTION.

      TLC Vision (USA) Corporation has caused this Amendment to be executed on
January 26, 2004.

                                            TLC VISION (USA) CORPORATION,
                                            Company

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Zindley L. Stahl                            By: /s/ Robert W. May
_______________________________             ____________________________________
Witness                                          Robert W. May
                                            Its: Secretary

Zindley L. Stahl                            /s/ Robert W. May
_______________________________             ____________________________________
Witness                                     Robert W. May, Trustee

Zindley L. Stahl                            /s/ B. Charles Bono III
_______________________________             ____________________________________
Witness                                     B. Charles Bono III, Trustee

Zindley L. Stahl                            /s/ Stephen Tucker
_______________________________             ____________________________________
Witness                                     Stephen Tucker, Trustee<PAGE>

                                                                     EXHIBIT 4.4

                                 AMENDMENT NO. 3
                                     TO THE
                    TLC VISION (USA) CORPORATION 401(k) PLAN
                AS AMENDED AND RESTATED JANUARY 1, 2004 ("PLAN")

      Pursuant to Section 10.01 of the TLC Vision (USA) Corporation 401(k), as
amended and restated as of January 1, 2004 ("Plan"), TLC Vision (USA)
Corporation hereby adopts this Amendment to the Plan, effective as of January 1,
2004, except as otherwise provided below.

      1.    EFFECTIVE AS OF JUNE 1, 2004, THE PLAN IS AMENDED BY THE ADDITION OF
A NEW SUBPARAGRAPH (h) TO SECTION 3.02 OF THE PLAN TO PERMIT CATCH-UP
CONTRIBUTIONS, AS FOLLOWS:

      (h)   Catch-up Contributions. Effective June 1, 2004, all Participants who
are eligible to make elective deferrals under the Plan and who have attained age
50 before the close of the Plan Year shall be eligible to make catch-up
contributions in accordance with, and subject to the limitations of, Code
Section 414(v). Such catch-up contributions shall not be taken into account for
purposes of the provisions of Section 3.02(c)(4), which provides for the
required limitations of Code Section 402(g), nor for purposes of Section 7.03,
which provides for the required limitations of Code Section 415. The Plan shall
not be treated as failing to satisfy the provisions of the Plan implementing the
requirements of Code Section 401(k)(3), 401(k)(11), 401(k)(12), 410(b), or 416,
as applicable, by reason of the making of such catch-up contributions. No
catch-up contribution made to the Plan shall be eligible for an Employer
matching contribution.

      2.    EFFECTIVE AS OF JANUARY 1, 2004, SECTION 3.03(b) OF THE PLAN IS
AMENDED TO READ AS FOLLOWS:

      (b)   Payment. The Employer's matching contribution if any, as determined
under paragraph (a), may be made in cash or in Employer Stock and shall be paid
to the Fund quarterly throughout each year, or as otherwise determined by the
Employer's board of directors, but in no event later than the due date
(including extensions) for the Employer's federal income tax return for the
taxable year of the Employer corresponding to the Plan Year to which the
matching contribution relates. Notwithstanding anything to the contrary, if for
any calendar quarter, the matching contribution is to be made in Employer Stock,
the shares of Employer Stock required for any such calendar quarter shall be
based on the value of Employer Stock on the first day of the applicable calendar
quarter or the value of Employer Stock on the last day of the applicable
calendar quarter, whichever value is lower.

      3.    EFFECTIVE FOR JANUARY 1, 2004, SECTION 4.01 OF THE PLAN IS AMENDED
TO READ AS FOLLOWS.

      SECTION 4.01 INVESTMENT ELECTIONS.

      (a)   Investment Options. A Participant who is in active employment of an
Employer or Other Employer, or who ceases to be so employed but elects a
deferred distribution of his Account, may invest all or part of his Before-Tax
Contribution, Rollover

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Contribution Account, and Employer Profit Sharing Contribution Account, if any,
and, after June 15, 2004, that portion of his Employer Matching Contribution
Account that is not Employer Stock, in any one or more of the investment fund or
funds as are made available from time to time by the Trustee at the direction of
the Plan Administrator. In no event, however, may a Participant direct
investment of any portion of his Account into Employer Stock.

      The Plan Administrator may from time to time change the available
investment funds. In such event, the Plan Administrator shall give reasonable
notification to Participants of such change. A Participant shall invest his
Account only in whole increments of one percent. In the absence of an election,
the Account shall be invested in the stable asset fund, money market fund, or
other similar investment alternative offered under the Plan.

      Any Employer Matching Contributions made in Employer Stock shall remain in
the Participant's Employer Matching Contribution Account as Employer Stock
unless or until reinvested by him into one or more of the investment funds
available under the Plan; provided, however, that in no event may a Participant
reinvest any of the Employer Stock allocated to his Employer Matching
Contribution Account until after June 15, 2004 and unless and until he is 100%
vested in his Employer Matching Contribution Account.

      Except as otherwise provided by law, the Trustee shall have no fiduciary
responsibility with respect to the selection of such investment funds nor in
connection with the investment choices made by Participants or dictated by the
Plan. The Trustee's only responsibility shall be with respect to the individual
investments of any investment funds that are offered and operated by the Trustee
and made available for Participant investment under the Plan, and which are not
controlled by an investment manager appointed pursuant to Section 8.06.

      (b)   Method of Election. Each Participant shall indicate his initial
election for investment of his Before-Tax, Rollover, or Employer Profit Sharing
Account, and that portion of his Employer Matching Contribution Account that is
not Employer Stock, if any, by filing a written designation upon enrollment with
the Plan Administrator on a form provided by the Plan Administrator. Thereafter,
any changes, including any change of his Employer Matching Contribution Account
out of Employer Stock, shall be arranged directly with the Trustee, by telephone
or otherwise as permitted under procedures established by the Trustee.

      (c)   Frequency of Election.

            (1) Future Contributions. With respect to future before-tax or
      profit sharing contributions, a Participant who is actively employed by an
      Employer or Other Employer may file a new designation at any time; the new
      designation shall become effective with respect to contributions made
      following the date on which the Trustee or his delegate receives the new
      designation. In the absence of a new election, future contributions shall
      be invested in the available funds in the same proportions as specified in
      the Participant's most recently filed election. Such designation also
      shall apply to Employer matching contributions that are made in cash, if
      any, but not to such contributions that are made in Employer Stock.

<PAGE>

            (2) Existing Accounts -- Interfund Transfers. With respect to his
      existing Before-Tax, Rollover, or Employer Profit Sharing Account balance,
      and that portion of his Employer Matching Contribution Account that is not
      Employer Stock, if any, a Participant who is actively employed by the
      Employer or Other Employer, or who ceases to be so employed but elects a
      deferred distribution of his Account, may change his election and request
      a transfer of monies from such Accounts among the available funds at any
      time. A Participant who is 100% vested in his Employer Matching
      Contribution Account may request, after June 15, 2004, a reinvestment of
      any portion of his Account held in Employer Stock at any time that trading
      of Employer Stock is permissible by persons subject to the Company's
      insider trading policy. All such investment changes shall become effective
      no later than the day that follows such request, or in the sole discretion
      of the Plan Administrator, at such later date as is appropriate to
      effectuate the Participant's new election without incurring significant
      losses or transactional costs or, if necessary, in order to comply with
      trade limitations imposed by the specific investment funds. The Plan
      Administrator shall direct the Trustee to transfer monies or other
      property from the appropriate fund to the other fund(s) as may be
      necessary to reflect the aggregate transfers of all Participants after the
      Plan Administrator has caused the necessary entries to be made to each
      Participant's interest in the funds and has reconciled offsetting transfer
      elections, in accordance with uniform rules established by the Plan
      Administrator.

      (d)   Effects of Investment Directions. A Participant directing investment
of his Account pursuant to this section shall be entitled only to those earnings
and investment gains or losses as are experienced by the segregated portion of
his Account affected by his direction (less any expense incurred by the Trustee
in carrying out the Participant's investment directions), plus any net change
allocated to the part of his Account, if any, that has not been segregated
and/or for which he does not direct investments.

      4.    SECTION 6.02(c) OF THE PLAN IS AMENDED TO READ AS FOLLOWS:

      (c)   Options. The following shall be the distribution options available
to a Participant (or his Beneficiary) who is entitled to receive benefits,
except as otherwise limited in paragraph (d) below:

            (1)   A single lump sum payment; or

            (2)   A direct rollover of all or a portion of the Participant's
      nonforfeitable Account balance to the trustee or other fiduciary of (A) a
      trust that is exempt under Code Section 501(a) and maintained in
      accordance with a plan described in Code Section 401(a), (B) an individual
      retirement account as described in Code Section 408(a) or an individual
      retirement annuity as described in Code Section 408(b), or (C) an annuity
      plan described in Code Section 403(a), provided that such plan, account or
      annuity accepts such distributions. This direct rollover option shall not
      be available with respect to any hardship distribution.

      A Participant shall receive an in-kind distribution of any whole shares of
Employer Stock that are held in the Participant's Employer Matching Contribution
Account as of the

<PAGE>

date the Participant's distribution election form is received by the Plan
Administrator. The value of any fractional shares shall be distributed in cash.
Except as provided above, the Participant shall not have any right to receive a
distribution in the form of Employer Stock. Prior to and as a condition of
receiving an in-kind distribution of Employer Stock, the Participant shall
execute such documents as the Employer deems reasonably necessary to comply with
then existing securities laws, including documents pertaining to restrictions on
transfer of Employer Stock.

      5.    SUBPARAGRAPHS (3) AND (4) OF SECTION 7.01(d) OF THE PLAN ARE AMENDED
TO READ AS FOLLOWS:

            (3)   Forfeitures. The forfeitable portion of a Participant's
      Employer Matching Contribution Account, and his Employer Profit Sharing
      Contribution Account, if any, shall be forfeited and returned to the Fund
      in accordance with the rules of this paragraph.

                  (A)   If the nonforfeitable balance of the Participant's
            Employer Matching Contribution Account and his Employer Profit
            Sharing Contribution Account is distributed in a single lump sum
            payment, the forfeiture shall occur upon distribution to the
            Participant of the vested portion of his Account.

                  (B)   If the nonforfeitable balance of the Participant's
            Employer Matching Contribution Account and his Employer Profit
            Sharing Contribution Account exceeds $5,000, and if the Participant
            does not consent to payment of this amount prior to his attainment
            of Normal Retirement Age, the forfeiture shall occur as of the last
            day of the Plan Year in which the Participant incurs his fifth
            consecutive one-year Break in Service.

                  (C)   If a Participant terminates employment at a time when he
            has no nonforfeitable right to any portion of his Account
            attributable to Employer Matching Contributions or Employer Profit
            Sharing Contributions, the Participant will be deemed to have
            received a distribution of such Accounts as of the date of his
            termination and a forfeiture of his entire Employer Matching
            Contribution Account balance and his Employer Profit Sharing
            Contribution Account balance shall occur on such termination date.

            (4)   Repayments. A Participant who has received a distribution of
      less than the full balance of his Account, and who returns to employment
      covered by the Plan prior to incurring five consecutive one-year Breaks in
      Service, may elect to repay to the Fund the full amount distributed and
      have his Account restored to the amount on the date of the distribution,
      unadjusted for any gains or losses occurring subsequent to the date of
      distribution, provided that such repayment is made prior to the earlier
      of: (A) five years after the date he resumes employment with the Employer,
      or (B) the last day of the Plan Year in which he incurs the fifth
      consecutive one-year Break in Service after receiving a distribution of
      less than the full balance of his Account. Restoration of his Account
      shall be made from forfeitures, or to the extent necessary, additional
      Employer contributions. Any

<PAGE>

      amount repaid by the Participant shall be aggregated in the Participant's
      Account with any restored forfeiture.

            In the case of a former Participant who was deemed to have received
      a distribution pursuant to subparagraph (3)(C) above and who resumes
      employment with the Employer before the date the former Participant incurs
      5 consecutive one-year Breaks in Service, the balance of his Employer
      Matching Contribution Account and Employer Profit Sharing Contribution
      Account, if any, shall be restored upon his reemployment to the amount on
      the date of such deemed distribution in the manner provided in the
      previous paragraph.

      6.    TLC VISION (USA) CORPORATION HAS CAUSED THIS AMENDMENT TO BE
EXECUTED ON MAY 21, 2004.

                                         TLC VISION (USA) CORPORATION,
                                         Company

/s/ Cindy Stahl                               /s/ Robert W. May
_______________________________          By:  __________________________________
Witness                                       Robert W. May
                                         Its: Secretary

                       [signatures continued on next page]

/s/ Cindy Stahl                             /s/ Robert W. May
_______________________________             ____________________________________
Witness                                     Robert W. May, Trustee

/s/ Cindy Stahl                             /s/ B. Charles Bono III
_______________________________             ____________________________________
Witness                                     B. Charles Bono III, Trustee

/s/ Cindy Stahl                             /s/ Stephen Tucker
_______________________________             ____________________________________
Witness                                     Stephen Tucker, Trustee

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