OMB No. 1210-0110 
       SCHEDULE R                                      Retirement Plan Information 
          (Form 5500) 
          Department of the Treasury         This schedule is required to be filed under sections 104 and 4065 of the                                                                           2023 
          Internal Revenue Service           Employee Retirement Income Security Act of 1974 (ERISA) and section 
           Department of Labor                         6058(a) of the Internal Revenue Code (the Code). 
   Employee Benefits Security Administration                                                                                                                                           This Form is Open to Public 
                                                           File as an attachment to Form 5500.
     Pension Benefit Guaranty Corporation                                                                                                                                                       Inspection. 
For calendar plan year 2023 or fiscal plan year beginning                                                                             and ending 
A  Name of plan                                                                                                                       B    Three-digit
ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI                                                                                      plan number 
ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI                                                                                      (PN)                                                              001 
ABCDEFGHI ABCDEFGHI  
C  Plan sponsor’s name as shown on line 2a of Form 5500                                                                               D    Employer Identification Number (EIN)
ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI                                                                                      012345678 
ABCDEFGHI  
  Part I       Distributions 
All references to distributions relate only to payments of benefits during the plan year. 

1    Total value of distributions paid in property other than in cash or the forms of property specified in the                                                                    1 
     instructions……………………………………………………………………………………………………………....                                                                              ..                                                  -123456789012345
2    Enter the EIN(s) of payor(s) who paid benefits on behalf of the plan to participants or beneficiaries during the year (if more than two, enter EINs of the 
     two payors who paid the greatest dollar amounts of benefits): 
      EIN(s):          _______________________________                         ________________________________  
     Profit-sharing plans, ESOPs, and stock bonus plans, skip line 3. 
3    Number of participants (living or deceased) whose benefits were distributed in a single sum, during the plan                                                                  3 
     year ......................................................................................................................................................................                          12345678 
  Part II       Funding Information (If the plan is not subject to the minimum funding requirements of section 412 of the Internal Revenue Code or
                ERISA section 302, skip this Part.) 
4   Is the plan administrator making an election under Code section 412(d)(2) or ERISA section 302(d)(2)? .......................      YesX                                                           NoX         X   N/A 
     If the plan is a defined benefit plan, go to line 8. 
5    If a waiver of the minimum funding standard for a prior year is being amortized in this 
     plan year, see instructions and enter the date of the ruling letter granting the waiver.                                    Date:    Month _________    Day _________    Year _________ 
      If you completed line 5, complete lines 3, 9, and 10 of Schedule MB and do not complete the remainder of this schedule. 
6    a    Enter the minimum required contribution for this plan year (include any prior year accumulated funding
                                                                                                                                                                                    6a          -123456789012345
          deficiency not waived ).....................................................................................................................................
    b    Enter the amount contributed by the employer to the plan for this plan year ...................................................                                           6b           -123456789012345
    c    Subtract the amount in line 6b from the amount in line 6a. Enter the result
           (enter a minus sign to the left of a negative amount) .......................................................................................                            6c          -123456789012345
     If you completed line 6c, skip lines 8 and 9. 
7    Will the minimum funding amount reported on line 6cSAMPLEbe met by the funding deadline? .........................................                                                    YesX       NoX         X   N/A 
8    If a change in actuarial cost method was made for this plan year pursuant to a revenue procedure or other 
     authority providing automatic approval for the change or a class ruling letter, does the plan sponsor or plan 
     administrator agree with the change? ....................................................................................................................                       X   Yes          NoX         X   N/A 

 Part III      Amendments 
9    If this is a defined benefit pension plan, were any amendments adopted during this plan 
     year that increased or decreased the value of benefits? If yes, check the appropriate 
     box. If no, check the “No” box. ........................................................................................... X  Increase                                      X Decrease    X  Both           X  No 
 Part IV        ESOPs (see instructions). If this is not a plan described under section 409(a) or 4975(e)(7) of the Internal Revenue Code, skip this Part.
10    Were unallocated employer securities or proceeds from the sale of unallocated securities used to repay any exempt loan?..............                                                       X  Yes           X   No 
11  a     Does the ESOP hold any preferred stock? ....................................................................................................................................            X  Yes           X   No 
     b    If the ESOP has an outstanding exempt loan with the employer as lender, is such loan part of a “back-to-back” loan?                                                                     X  Yes           X   No 
          (See instructions for definition of “back-to-back” loan.) ..................................................................................................................  
12   Does the ESOP hold any stock that is not readily tradable on an established securities market? ........................................................                                      X  Yes           X   No 
For Paperwork Reduction Act Notice, see the Instructions for Form 5500.                                                                                                                Schedule R (Form 5500) 2023 
                                                                                                                                                                                                            v. 230728

      Schedule R (Form 5500) 2023                                                     Page 2 - 1- x

Part V     Additional Information for Multiemployer Defined Benefit Pension Plans 
13 Enter the following information for each employer that (1) contributed more than 5% of total contributions to the plan during the plan year or (2) was one of
   the top-ten highest contributors (measured in dollars). See instructions. Complete as many entries as needed to report all applicable employers. 
   a  Name of contributing employer 
   b  EIN                                                                     c    Dollar amount contributed by employer 
   d  Date collective bargaining agreement expires (If employer contributes under more than one collective bargaining agreement, check box X    
      and see instructions regarding required attachment. Otherwise, enter the applicable date.)    Month _______    Day _______    Year _______ 
   e  Contribution rate information (If more than one rate applies, check this box  Xand see instructions regarding required attachment.  Otherwise, 
      complete lines 13e(1) and 13e(2).) 
      (1)  Contribution rate (in dollars and cents)  _____________
      (2)  Base unit measure: X     Hourly             X Weekly             X Unit of production             X Other (specify): 
   a  Name of contributing employer 
   b  EIN                                                                     c    Dollar amount contributed by employer
   d  Date collective bargaining agreement expires (If employer contributes under more than one collective bargaining agreement, check box X    
      and see instructions regarding required attachment. Otherwise, enter the applicable date.)    Month _______    Day _______    Year _______ 
   e  Contribution rate information (If more than one rate applies, check this box  Xand see instructions regarding required attachment.  Otherwise, 
      complete lines 13e(1) and 13e(2).) 
      (1)  Contribution rate (in dollars and cents)  _____________
      (2)  Base unit measure: X     Hourly             X Weekly             X Unit of production             X Other (specify): _______________________________ 
   a  Name of contributing employer 
   b  EIN                                                                     c    Dollar amount contributed by employer
   d  Date collective bargaining agreement expires (If employer contributes under more than one collective bargaining agreement, check box X    
      and see instructions regarding required attachment. Otherwise, enter the applicable date.)    Month _______    Day _______    Year _______ 
   e  Contribution rate information (If more than one rate applies, check this box  Xand see instructions regarding required attachment.  Otherwise, 
      complete lines 13e(1) and 13e(2).) 
      (1)  Contribution rate (in dollars and cents)  _____________
      (2)  Base unit measure: X     Hourly             X Weekly             X Unit of production             X Other (specify): _______________________________ 

   a  Name of contributing employer
   b  EIN                                                                     c    Dollar amount contributed by employer
   d  Date collective bargaining agreement expires (If employer contributes under more than one collective bargaining agreement, check box X    
      and see instructions regarding required attachment. Otherwise, enter the applicable date.)    Month _______    Day _______    Year _______ 
   e  Contribution rate information (If more than one rate applies, check this box  Xand see instructions regarding required attachment.  Otherwise, 
      complete lines 13e(1) and 13e(2).) 
      (1)  Contribution rate (in dollars and cents)  _____________
      (2)  Base unit measure: X     Hourly             X Weekly             X Unit of production             X Other (specify): _______________________________ 

   a  Name of contributing employer
                                                         SAMPLE
   b  EIN                                                                     c    Dollar amount contributed by employer
   d  Date collective bargaining agreement expires (If employer contributes under more than one collective bargaining agreement, check box X    
      and see instructions regarding required attachment. Otherwise, enter the applicable date.)    Month _______    Day _______    Year _______ 
   e  Contribution rate information (If more than one rate applies, check this box  Xand see instructions regarding required attachment.  Otherwise, 
      complete lines 13e(1) and 13e(2).) 
      (1)  Contribution rate (in dollars and cents)  _____________
      (2)  Base unit measure: X     Hourly             X Weekly             X Unit of production             X Other (specify): _______________________________ 

   a  Name of contributing employer
   b  EIN                                                                     c    Dollar amount contributed by employer
   d  Date collective bargaining agreement expires (If employer contributes under more than one collective bargaining agreement, check box X    
      and see instructions regarding required attachment. Otherwise, enter the applicable date.)    Month _______    Day _______    Year _______ 
   e  Contribution rate information (If more than one rate applies, check this box  Xand see instructions regarding required attachment.  Otherwise, 
      complete lines 13e(1) and 13e(2).) 
      (1)  Contribution rate (in dollars and cents)  _____________
      (2)  Base unit measure: X     Hourly             X Weekly             X Unit of production             X Other (specify): _______________________________ 

        Schedule R (Form 5500) 2023                                                       Page 3

14  Enter the number of deferred vested and retired participants (inactive participants), as of the beginning of the
    plan year, whose contributing employer is no longer making contributions to the plan for:                                                                          123456789012345 
     a The current plan year. Check the box to indicate the counting method used to determine the number of
    inactive participants:    Xlast contributing employer    Xalternative     reasonableX approximation (see                                                       14a 
    instructions for required attachment) .......................................................................................................................  
    b  The plan year immediately preceding the current plan year.   XCheck the box if the number reported is a                                                     14b 
    change from what was previously reported (see instructions for required attachment) ..........................................                                     123456789012345 
    c  The second preceding plan year.   XCheck the box if the number reported is a change from what was                                                           14c 
    previously reported (see instructions for required attachment)................................................................................                     123456789012345 
15  Enter the ratio of the number of participants under the plan on whose behalf no employer had an obligation to make an
    employer contribution during the current plan year to: 
    a  The corresponding number for the plan year immediately preceding the current plan year .............................                                        15a 123456789012345 
    b  The corresponding number for the second preceding plan year .......................................................................                         15b 123456789012345 
16  Information with respect to any employers who withdrew from the plan during the preceding plan year: 
    a  Enter the number of employers who withdrew during the preceding plan year   ..............................................                                  16a 123456789012345 

    b  If line 16a is greater than 0, enter the aggregate amount of withdrawal liability assessed or estimated to be                                               16b 123456789012345 
       assessed against such withdrawn employers ...................................................................................................  
17  If assets and liabilities from another plan have been transferred to or merged with this plan during the plan year, check box and see instructions regarding
    supplemental information to be included as an attachment..................................................................................................................................................... X 
Part VI      Additional Information for Single-Employer and Multiemployer Defined Benefit Pension Plans 
18  If any liabilities to participants or their beneficiaries under the plan as of the end of the plan year consist (in whole or in part) of liabilities to such
    participants and beneficiaries under two or more pension plans as of immediately before such plan year, check box and see instructions regarding 
    supplemental information to be included as an attachment..................................................................................................................................................... X 

19  If the total number of participants is 1,000 or more, complete lines (a) and (b): 
    a  Enter the percentage of plan assets held as: 
        Public Equity: _____%   Private Equity: _____%    Investment-Grade Debt and Interest Rate Hedging Assets: _____%    
        High-Yield Debt: _____%   Real Assets: _____%    Cash or Cash Equivalents: _____%    Other: _____ %
    b  Provide the average duration of the Investment-Grade Debt and Interest Rate Hedging Assets:   
       X  0-5 years        X 5-10 years        X 10-15 years       X 15 years or more  
20  PBGC missed contribution reporting requirements. If this is a multiemployer plan or a single-employer plan that is not covered by PBGC, skip line 20.
    a  Is the amount of unpaid minimum required contributions for all years from Schedule SB (Form 5500) line 40 greater than zero?                                      Yes    No
    b  If line 20a is “Yes,” has PBGC been notified as required by ERISA sections 4043(c)(5) and/or 303(k)(4)? Check the applicable box: 
          Yes. 
       _  No. Reporting was waived under 29 CFR 4043.25(c)(2) because contributions equal to or exceeding the unpaid minimum required contribution 
             were made by the 30th day after the due date. 
       _  No. The 30-day period referenced in 29 CFR 4043.25(c)(2) has not yet ended, and the sponsor intends to make a contribution equal to or 
             exceeding the unpaid minimum required contribution by the 30th day after the due date. 
       _  No. Other. Provide explanation.__________________________________________________________________________________________SAMPLE

Part VII     IRS Compliance Questions 
21a Does the plan satisfy the coverage and nondiscrimination tests of Code sections 410(b) and 401(a)(4) by combining this plan with any other plans under
    the permissive aggregation rules?   Yes        No 
21b If this is a Code section 401(k) plan, check all boxes that apply to indicate how the plan is intended to satisfy the nondiscrimination requirements for
    employee deferrals and employer matching contributions (as applicable) under Code sections 401(k)(3) and 401(m)(2). 
       _ Design-based safe harbor method 
       _ “Prior year” ADP test 
       _ “Current year” ADP test  
       _ N/A 
22  If the plan sponsor is an adopter of a pre-approved plan that received a favorable IRS Opinion Letter, enter the date of the Opinion Letter ___/___/_____
    (MM/DD/YYYY) and the Opinion Letter serial number__________.