Revive N.S.B LLC

Form 5500

REVIVE N.S.B., LLC DBA PRIME IV HYDRATION

505 Canal Street, New Smyrna Beach, FL 32168 (407) 493-5590 EIN:84-1954050 Plan Admin:Stacia Politowicz

Year	Plan Name	Participants BOY/EOY	Assets BOY/EOY
2022	Plan NamePRIME IV HYDRATION 401(K) PROFIT SHARING PLAN Plan #001 Participants BOY/EOY14 / 19 Assets BOY/EOY$25,660 / $53,462	2022	PRIME IV HYDRATION 401(K) PROFIT SHARING PLAN - Plan #001	14 / 19	$25,660 / $53,462
2021	Plan NamePRIME IV HYDRATION 401(K) PROFIT SHARING PLAN Plan #001 Participants BOY/EOY4 / 12 Assets BOY/EOY$467 / $25,660	2021	PRIME IV HYDRATION 401(K) PROFIT SHARING PLAN - Plan #001	4 / 12	$467 / $25,660
2020	Plan NamePRIME IV HYRDATION 401(K) PROFIT SHARING PLAN Plan #001 Participants BOY/EOY0 / 3 Assets BOY/EOY$0 / $467	2020	PRIME IV HYRDATION 401(K) PROFIT SHARING PLAN - Plan #001	0 / 3	$0 / $467