Buyout - Ademi & Fruchter LLP

Name

First Name *

Middle Initial

Last Name *

Institution Name (if applicable)

Position In Institution (if applicable)

Address

Address More

City

State

ZIP / Postal Code

Phone *

Email *

Currently Hold Shares (Buyout)

I currently hold shares of the company involved in this investigation or action.

Additional Questions (Buyout)

Check this box if you would like to answer a few additional questions now about your stock transactions (questions will appear below). You may uncheck this box at any time if you change your mind before submitting this form.

Additional (Buyout)

Employee *

Are you a current or former employee of the company FONAR Corporation?

Certification

I, the Plaintiff, certify that:

My transactions in the securities, which are the subject of this action, during the Class Period set forth in the Complaint are as follows:

True & Correct *

I declare under penalty of perjury that the foregoing are true and correct statements.

Signature

Date of Signing

Date of Signing: 12/31/2025

1	Share Info # of Shares Buy Date Price per Share
1	Share Info # of Shares Buy Date Price per Share

1	Share Info # of Shares Sell Date Price per Share
1	Share Info # of Shares Sell Date Price per Share