File Number 0008378766   Application Status M - Consummated     General Information Application Purpose TC - Transfer of Control Receipt Date 10/09/2018    Entered Date 10/09/2018  Action Date 11/28/2018  Waiver No   Number of Rules   Attachments Yes     Application Fee Exempt Yes   Waiver/Deferral Fee

Licensee Information FRN 0003272564 (View Ownership Filing)   Type Other Non-profit corporation Name Chambersburg Hospital ATTN Sam Shatzer 112 North 7th Street Chambersburg, PA 17201     P:(717)267-7921  F:(717)267-7770  E:sshatzer@summithealth.org    Race   Gender   Ethnicity       Licensee Contact Information Name Pepper Hamilton LLP Marc D Machlin ATTN Marc D. Machlin 600 14th Street, N.W., Suite 500 Washington, DC 20005   P:(202)220-1439  F:(202)220-1665  E:machlinm@pepperlaw.com      Transferor Information FRN 0003272564 (View Ownership Filing)   Type Other Non-profit corporation Name Summit Health ATTN Sam Shatzer 112 North 7th Street Chambersburg, PA 17201     P:(717)267-7921  F:(717)267-7770  E:sshatzer@summithealth.org    Race   Gender   Ethnicity       Transferor Contact Information Name Pepper Hamilton LLP Marc D Machlin ATTN Marc D. Machlin 600 14th Street, N.W., Suite 500 Washington, DC 20005   P:(202)220-1439  F:(202)220-1665  E:machlinm@pepperlaw.com      Transferee Information FRN 0024709909 (View Ownership)   Type Other Non-Profit Corporation Name WellSpan Health ATTN General Counsel P.O. Box 2767 York, PA 17405     P:(717)851-3055    Real Party In Interest WellSpan Health  FRN of Real Party in Interest 0024709909  Race   Gender   Ethnicity       Transferee Contact Information Name WellSpan Health ATTN General Counsel P.O. Box 2767 York, PA 17405-2767   P:(717)851-3055

Transferee Qualifications and Ownership Information

Alien Ownership Is the Post-Transfer Licensee a foreign government or the representative of any foreign government? No   Is the Post-Transfer Licensee an alien or the representative of an alien?   Is the Post-Transfer Licensee a corporation organized under the laws of any foreign government?   Is the Post-Transfer Licensee a corporation of which more than one-fifth of the capital stock is owned of record or voted by aliens or their representatives or by a foreign government or representative thereof or by any corporation organized under the laws of a foreign country?   Is the Post-Transfer Licensee directly or indirectly controlled by any other corporation of which more than one-fourth of the capital stock is owned of record or voted by aliens, their representatives, or by a foreign government or representative thereof, or by any corporation organized under the laws of a foreign country?   The Alien Ruling question is not answered.   Basic Qualifications The Applicant answered "No" to each of the Basic Qualification questions.