Form 5500 Schedule DFE/Participating Plan Information

Annual Information Return/Report of Employee Benefit Plan

250312 Sch D - Clean

Annual Information Return/Report of Employee Benefit Plan

OMB: 1210-0110

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SCHEDULE D

(Form 5500)


Department of the Treasury

Internal Revenue Service


Department of Labor

Employee Benefits Security Administration




DFE/Participating Plan Information


This schedule is required to be filed under section 104 of the Employee Retirement Income Security Act of 1974 (ERISA).

File as an attachment to Form 5500.



OMB No. 1210-0110


2025


This Form is Open to Public Inspection.

For calendar plan year 2025 or fiscal plan year beginning and ending

A Name of plan



B Three-digit
plan number (PN)



C Plan or DFE sponsor’s name as shown on line 2a of Form 5500


D Employer Identification Number (EIN)

Part I

Information on interests in MTIAs, CCTs, PSAs, and 103-12 IEs (to be completed by plans and DFEs)
(Complete as many entries as needed to report all interests in DFEs)

a Name of MTIA, CCT, PSA, or 103-12 IE:


b Name of sponsor of entity listed in (a):


c EIN-PN


d Entity code


e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions)





a Name of MTIA, CCT, PSA, or 103-12 IE:


b Name of sponsor of entity listed in (a):


c EIN-PN


d Entity code


e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions)





a Name of MTIA, CCT, PSA, or 103-12 IE:


b Name of sponsor of entity listed in (a):


c EIN-PN


d Entity code


e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions)





a Name of MTIA, CCT, PSA, or 103-12 IE:


b Name of sponsor of entity listed in (a):


c EIN-PN


d Entity code


e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions)



a Name of MTIA, CCT, PSA, or 103-12 IE:


b Name of sponsor of entity listed in (a):


c EIN-PN


d Entity code


e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions)



a Name of MTIA, CCT, PSA, or 103-12 IE:


b Name of sponsor of entity listed in (a):


c EIN-PN


d Entity code


e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions)



a Name of MTIA, CCT, PSA, or 103-12 IE:


b Name of sponsor of entity listed in (a):


c EIN-PN


d Entity code


e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions)



For Paperwork Reduction Act Notice, see the Instructions for Form 5500.


Schedule D (Form 5500) 2025

v. 250312



a Name of MTIA, CCT, PSA, or 103-12 IE:


b Name of sponsor of entity listed in (a):


c EIN-PN


d Entity code


e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions)



a Name of MTIA, CCT, PSA, or 103-12 IE:


b Name of sponsor of entity listed in (a):


c EIN-PN


d Entity code


e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions)



a Name of MTIA, CCT, PSA, or 103-12 IE:


b Name of sponsor of entity listed in (a):


c EIN-PN


d Entity code


e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions)



a Name of MTIA, CCT, PSA, or 103-12 IE:


b Name of sponsor of entity listed in (a):


c EIN-PN


d Entity code


e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions)



a Name of MTIA, CCT, PSA, or 103-12 IE:


b Name of sponsor of entity listed in (a):


c EIN-PN


d Entity code


e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions)



a Name of MTIA, CCT, PSA, or 103-12 IE:


b Name of sponsor of entity listed in (a):


c EIN-PN


d Entity code


e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions)



a Name of MTIA, CCT, PSA, or 103-12 IE:


b Name of sponsor of entity listed in (a):


c EIN-PN


d Entity code


e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions)



a Name of MTIA, CCT, PSA, or 103-12 IE:


b Name of sponsor of entity listed in (a):


c EIN-PN


d Entity code


e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions)



a Name of MTIA, CCT, PSA, or 103-12 IE:


b Name of sponsor of entity listed in (a):


c EIN-PN


d Entity code


e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions)



a Name of MTIA, CCT, PSA, or 103-12 IE:


b Name of sponsor of entity listed in (a):


c EIN-PN


d Entity code


e Dollar value of interest in MTIA, CCT, PSA, or 103-12 IE at end of year (see instructions)



6

Part II

Information on Participating Plans (to be completed by DFEs, other than DCGs)
(Complete as many entries as needed to report all participating plans. DCGs must report each participating plan using Schedule DCG.)

a Plan name



b Name of
plan sponsor



c EIN-PN



a Plan name



b Name of
plan sponsor



c EIN-PN


a Plan name



b Name of
plan sponsor



c EIN-PN



a Plan name



b Name of
plan sponsor



c EIN-PN



a Plan name



b Name of
plan sponsor



c EIN-PN



a Plan name



b Name of
plan sponsor



c EIN-PN



a Plan name



b Name of
plan sponsor



c EIN-PN



a Plan name



b Name of
plan sponsor



c EIN-PN



a Plan name



b Name of
plan sponsor



c EIN-PN



a Plan name



b Name of
plan sponsor



c EIN-PN



a Plan name


b Name of
plan sponsor



c EIN-PN



a Plan name



b Name of
plan sponsor



c EIN-PN



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File Title2024 Schedule D
AuthorUnited States Department of Labor
File Created2025:05:19 04:39:08Z

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