OMB No. 1210-0110 
    SCHEDULE MB                              Multiemployer Defined Benefit Plan and Certain 
         (Form 5500)                         Money Purchase Plan Actuarial Information 
                                                                                                                                                                                  2023 
        Department of the Treasury 
         Internal Revenue Service            This schedule is required to be filed under section 104 of the Employee 
             Department of Labor             Retirement Income Security Act of 1974 (ERISA) and section 6059 of the                                                       This Form is Open to Public 
   Employee Benefits Security Administration                      Internal Revenue Code (the Code).                                                                               Inspection 
    Pension Benefit Guaranty Corporation 
                                                    File as an attachment to Form 5500 or 5500-SF.
For calendar plan year 2023 or fiscal plan year beginning                                                                       and ending   
Round off amounts to nearest dollar.
Caution: A penalty of $1,000 will be assessed for late filing of this report unless reasonable cause is established. 
A  Name of plan                                                                                                                B                                 Three-digit 
ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI                                                                                                      plan number (PN)                     001 
ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI 
ABCDEFGHI ABCDEFGHI  
C  Plan sponsor’s name as shown on line 2a of Form 5500 or 5500-SF                                                             D    Employer Identification Number (EIN)
ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI                                                                                                      012345678 
ABCDEFGHI  
E  Type of plan:            (1)      XMultiemployer Defined Benefit                              (2)      XMoney Purchase (see instructions) 
1a  Enter the valuation date:                       Month _________    Day _________    Year _________ 
  b Assets
    (1)  Current value of assets .........................................................................................................................       1b(1) 
    (2)  Actuarial value of assets for funding standard account.........................................................................                         1b(2) 
  c  (1) Accrued liability for plan using immediate gain methods ......................................................................                          1c(1) 
    (2)  Information for plans using spread gain methods:
         (a) Unfunded liability for methods with bases ....................................................................................                      1c(2)(a)    -123456789012345
         (b) Accrued liability under entry age normal method ............................................................................                        1c(2)(b)    -123456789012345
         (c) Normal cost under entry age normal method .................................................................................                         1c(2)(c)    -123456789012345
    (3)  Accrued liability under unit credit cost method ......................................................................................                  1c(3)       -123456789012345
  d Information on current liabilities of the plan:
    (1)  Amount excluded from current liability attributable to pre-participation service (see instructions) ........                                            1d(1)       -123456789012345
    (2)  “RPA ‘94” information:
         (a) Current liability ................................................................................................................................  1d(2)(a)    -123456789012345
         (b) Expected increase in current liability due to benefits accruing during the plan year ......................                                         1d(2)(b)    -123456789012345
         (c) Expected release from “RPA ‘94” current liability for the plan year ................................................                                1d(2)(c)    -123456789012345
    (3)  Expected plan disbursements for the plan year ....................................................................................                      1d(3)       -123456789012345
Statement by Enrolled Actuary 
   To the best of my knowledge, the information supplied in this schedule and accompanying schedules, statements and attachments, if any, is complete and accurate. Each prescribed assumption was applied 
   in accordance with applicable law and regulations. In my opinion, each other assumption is reasonable (taking into account the experience of the plan and reasonable expectations) and such other 
   assumptions, in combination, offer my best estimate of anticipated experience under the plan. 
 SIGN 
                                                       SAMPLE
 HERE 
                                             Signature of actuary                                                                                                            Date 

                                   Type or print name of actuary                                                                                                 Most recent enrollment number 

                                             Firm name                                                                                       Telephone number (including area code) 
123456789 ABCDEFGHI ABCDEFGHI ABCDE 
123456789 ABCDEFGHI ABCDEFGHI ABCDE 
UK 
                                             Address of the firm 
If the actuary has not fully reflected any regulation or ruling promulgated under the statute in completing this schedule, check the box and see                                                     X 
instructions 
For Paperwork Reduction Act Notice, see the Instructions for Form 5500 or 5500-SF.                                                                                        Schedule MB (Form 5500) 2023 
                                                                                                                                                                                               v. 230728

          Schedule MB (Form 5500) 2023                                                      Page 2 -                                       1  x 
2 Operational information as of beginning of this plan year: 
 a  Current value of assets (see instructions)  ...................................................................................................                         2a -123456789012345
 b  “RPA…………………………(1) Number of participants                                                                                                                                   (2)Current liability                          ‘94” current liability/participant count breakdown: 
    ………………………………………………………………………………………………………......
    (1) For retired participants and beneficiaries receiving payment .................................                                     12345678                            -123456789012345
    (2) For terminated vested participants .........................................................................                       12345678                            -123456789012345
    (3) For active participants:
        (a)  Non-vested benefits .........................................................................................                                                     -123456789012345
        (b)  Vested benefits ................................................................................................                                                  -123456789012345
        (c)  Total active .......................................................................................................                                              -123456789012345
    (4) Total........................................................................................................................      12345678                            -123456789012345

 c  If the percentage resulting from dividing line 2a by line 2b(4), column (2), is less than 70%, enter such                                                               2c                                    123.12% 
    percentage ...........................................................................................................................................................  
3 Contributions made to the plan for the plan year by employer(s) and employees: 
    (a) Date           (b) Amount paid by      (c) Amount paid by                (a) Date                                                  (b) Amount paid by                  c) Amount paid by
 (MM/DD/YYYY)                 employer(s)                   employees           (MM/DD/YYYY)                                               employer(s)                              employees

                                   Totals
                                    
                                                                               Totals  ►                                              3(b)                                     3(c) 
(d) Total withdrawal liability amounts included in line 3(b) total .................................................................................................           3(d) 
4 Information on plan status: 
 a  Funded percentage for monitoring plan’s status (line 1b(2) divided by line 1c(3)) ............................................                                          4a                                            % 
 b  Enter code to indicate plan’s status (see instructions for attachment of supporting evidence of plan’s                                 status).                         4b 
    If entered code is “N,” go to line 5  ....................................................................................................................  
 c  Is the plan making the scheduled progress under any applicable funding improvement or rehabilitation plan? ........................................................ X Yes X No 
 d  If the plan is in critical status or critical and declining status, does line 1(c) reflect any benefit reductions for the first time
    (see instructions)? ......................................................................................................................................................................................... X Yes X No 

 e  If line d is “Yes,” enter the reduction in liability resulting from the reduction in benefits (see instructions),                                                       4e -123456789012345
    measured as of the valuation date  ...................................................................................................................  
  f If the plan is in critical status or critical and declining status, and is:
    •Projected to emerge from critical status within 30 years, enter the plan year in which it is projected to
    emerge;
    •Projected to become insolvent within 30 years, enter the plan year in which insolvency is expected and                                                                 4f 
    check   X                                                                                                                                                                                                                here………………….…...…...…...…...…...…...…...…...…...…...…...…...…...…...…...…...…...…..
    • Neither projected to emerge from critical status nor become insolvent within 30 years, enter “9999.”

5 Actuarial cost method used as the basis for this plan year’s funding standard account computations (check all that apply): 
 a   X    Attained age normal            b  X  Entry ageSAMPLEnormal             c     X                                          Accrued benefit (unit credit)                d    X Aggregate
 e   X    Frozen initial liability       f  X  Individual level premium          g     X  Individual aggregate                                                                 h    X  Shortfall
 i   X    Other (specify):_ 
____________________________________________________________________________
 j  If box h is checked, enter period of use of shortfall method ..............................................................................                             5j        YYYY-MM-DD 
 k  Has a change been made in funding method for this plan year? ................................................................................................................. X Yes X No 
 l  If line k is “Yes,” was the change made pursuant to Revenue Procedure 2000-40 or other automatic approval? ....................................... X Yes X No 
 mIf line k is l                                             /DD/YYYY) of the ruling letter (individual or class)                                                           5m        YYYY-MM-DD                             “Yes,” and line is “No,” enter the date (MM
    approving the change in funding method ..........................................................................................................  

         Schedule MB (Form 5500) 2023                                                                                Page 3 - 1  x 
6 Checklist of certain actuarial assumptions: 
 a  Interest rate for “RPA ‘94” current liability................................................................................................................................  6a          123.12% 
                                                                                                                       Pre-retirement                                               Post-retirement 
 b  Rates specified in insurance or annuity contracts .....................................                          X Yes   X No X N/A                                           X Yes   X No X N/A 
 c  Mortality table code for valuation purposes:
    (1)  Males ................................................................................. 6c(1) 
    (2)  Females ............................................................................    6c(2) 
 d  Valuation liability interest rate ..................................................             6d                                                          123.12%                       123.12% 
 e  Salary scale .............................................................................       6e 123.12%                                                  X N/A  
  f Withdrawal liability interest rate: 
    (1)  Type of interest rate ...........................................................       6f(1)                X Single rate     X ERISA 4044                      X        Other     X N/A  
    (2)  If “Single rate” is checked in (1), enter applicable single rate                         ..........................................................     6f(2)                                 % 
 g  Estimated investment return on actuarial value of assets for year ending on the valuation date ...........                                                   6g                            -123.1%
 h  Estimated investment return on current value of assets for year ending on the valuation date .............                                                   6h                            -123.1%
 i  Expense load included in normal cost reported in line 9b  .....................................................................                              6i                           X N/A 
    (1)  If expense load is described as a percentage of normal cost, enter the assumed percentage .......                                                       6i(1)                                 % 
    (2)  If expense load is a dollar amount that varies from year to year, enter the dollar amount included                                                      6i(2) 
         in line 9b ...........................................................................................................................................  
    (3)  If neither (1) nor (2) describes the expense load, check the box .....................................................                                  6i(3)                        X 
7 New amortization bases established in the current plan year: 
                (1) Type of base                                                                 (2) Initial balance                                              (3) Amortization Charge/Credit
                       A                                                                             -123456789012345                                                             -123456789012345
                       A                                                                             -123456789012345                                                             -123456789012345
                       A                                                                             -123456789012345                                                             -123456789012345
8 Miscellaneous information: 
 a  If a waiver of a funding deficiency has been approved for this plan year, enter the date                                                                     8a 
    (MM/DD/YYYY) of the ruling letter granting the approval .......................................................................                                                 YYYY-MM-DD 
 b  Demographic, benefit, and contribution information
    (1)  Is the plan required to provide a projection of expected benefit payments? (See instructions)                         If see                                                        X Yes   X No “Yes,”
         instructions for required attachment.  ...............................................................................................................................
    (2)  Is the plan required to provide a Schedule of Active Participant Data? (See instructions).  ............................................                                            X Yes   X No 
    (3)  Is the plan required to provide a projection of employer contributions and withdrawal liability payments? (See                                                                      X Yes   X No 
         instructions) If “Yes,” attach a schedule.
 c  AreX                                                                                                                                                                                       Yes   X No any of the plan’s amortization bases operating under an extension of time under section 412(e) (as in effect 
    prior to 2008) or section 431(d) of the Code?  ...............................................................................................................  
 d  If line c is “Yes,” provide the following additional information: 
    (1)  Was an extension granted automatic approval underSAMPLEsection 431(d)(1) of the Code? ...................                                                                           X Yes   X No 
    (2)  If line 8d(1) is “Yes,” enter the number of years by which the amortization period was extended                          ..                             8d(2)                              12 
    (3)  Was an extension approved by the Internal Revenue Service under section 412(e) (as in effect                                                                                        X Yes   X No 
         prior to 2008) or 431(d)(2) of the Code? .........................................................................................  
    (4)  If8d(4)                                                                                                                                                                                    12    line 8d(3) is “Yes,” enter number of years by which the amortization period was extended (not 
         including the number of years in line (2)) ........................................................................................  
    (5)  If line 8d(3) is “Yes,” enter the date of the ruling letter approving the extension ............................                                        8d(5)                 YYYY-MM-DD 
    (6)  IfX                                                                                                                                                                                   Yes   X No line 8d(3) is “Yes,” is the amortization base eligible for amortization using interest rates 
         applicable under section 6621(b) of the Code for years beginning after 2007? .............................  
 e  If box 5h is checked or line 8c is “Yes,” enter the difference between the minimum required
    contribution for the year and the minimum that would have been required without using the shortfall                                                          8e 
    method or extending the amortization base(s) .......................................................................................                                          -123456789012345
9 Funding standard account statement for this plan year:  
 Charges to funding standard account: 
 a  Prior year funding deficiency, if any ........................................................................................................               9a               -123456789012345
 b  Employer’s normal cost for plan year as of valuation date .....................................................................                              9b               -123456789012345

       Schedule MB (Form 5500) 2023                                                                                  Page 4 

c  Amortization charges as of valuation date:                                                                        Outstanding balance
   (1) All bases except funding waivers and certain bases for which the                                        9c(1) -123456789012345                               -123456789012345
       amortization period has been extended ..................................................  
   (2) Funding waivers ......................................................................................  9c(2) -123456789012345                               -123456789012345
   (3) Certain bases for which the amortization period has been extended .....                                 9c(3) -123456789012345                               -123456789012345
d  Interest as applicable on lines 9a, 9b, and 9c ........................................................................................                 9d       -123456789012345
e  Total charges. Add lines 9a through 9d ..................................................................................................               9e       -123456789012345
 Credits to funding standard account :
f  Prior year credit balance, if any ..............................................................................................................        9f       -123456789012345
g  Employer contributions. Total from column (b) of line 3 .........................................................................                       9g       -123456789012345
                                                                                                                     Outstanding balance 
h  Amortization credits as of valuation date ......................................................            9h    -123456789012345                               -123456789012345
i  Interest as applicable to end of plan year on lines 9f, 9g, and 9h ..........................................................                           9i       -123456789012345
j  Full funding limitation (FFL) and credits:
   (1) ERISA FFL (accrued liability FFL) ........................................................              9j(1) -123456789012345
   (2) “RPA ‘94” override (90% current liability FFL)  .....................................                   9j(2) -123456789012345
   (3) FFL credit .......................................................................................................................................  9j(3)    -123456789012345
k  (1) Waived funding deficiency ..............................................................................................................            9k(1)    -123456789012345
   (2) Other credits ...................................................................................................................................   9k(2)    -123456789012345
l  Total credits. Add lines 9f through 9i, 9j(3), 9k(1), and 9k(2) .................................................................                       9l       -123456789012345
m Credit balance: If line 9l is greater than line 9e, enter the difference .....................................................                           9m       -123456789012345
n  Funding deficiency: If line 9e is greater than line 9l, enter the difference ..............................................                             9n       -123456789012345
o  Current year’s accumulated reconciliation account:
   (1) Due to waived funding deficiency accumulated prior to the current plan year ...............................                                         9o(1) 
   (2) Due to amortization bases extended and amortized using the interest rate under section 6621(b) of the Code:
       (a)  Reconciliation outstanding balance as of valuation date .........................................................                              9o(2)(a) -123456789012345
       (b)  Reconciliation amount (line 9c(3) balance minus line 9o(2)(a)) ...............................................                                 9o(2)(b) -123456789012345
   (3) Total as of valuation date ...............................................................................................................          9o(3)    -123456789012345
10 Contribution necessary to avoid an accumulated funding deficiency. (see instructions.) ............................                                     10       -123456789012345
11 Has  ................. .                                                                                                                                         X Yes   X No    a change been made in the actuarial assumptions for the current plan year? If “Yes,” see instructions

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