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| Plan Name | BLACK SWAMP WELFARE PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | BLACK SWAMP |
| Employer identification number (EIN): | 821656715 |
| NAIC Classification: | 531310 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2022-05-01 | TIFFANY BOSCH | 2023-11-09 |
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