Five on Black Inc.

Form 5500

FIVE ON BLACK, INC.

325 North Higgins, Missoula, Mt 59802 (406) 546-8007 EIN:45-2954329 Plan Admin:Thomas M. Snyder

Year	Plan Name	Participants BOY/EOY	Assets BOY/EOY
2023	Plan NameFIVE ON BLACK, INC. 401(K) PLAN & TRUST Plan #001 Participants BOY/EOY25 / 28 Assets BOY/EOY$371,079 / $544,470	2023	FIVE ON BLACK, INC. 401(K) PLAN & TRUST - Plan #001	25 / 28	$371,079 / $544,470
2022	Plan NameFIVE ON BLACK, INC. 401(K) PLAN & TRUST Plan #001 Participants BOY/EOY28 / 32 Assets BOY/EOY$403,049 / $371,079	2022	FIVE ON BLACK, INC. 401(K) PLAN & TRUST - Plan #001	28 / 32	$403,049 / $371,079
2021	Plan NameFIVE ON BLACK, INC. 401(K) PLAN & TRUST Plan #001 Participants BOY/EOY18 / 25 Assets BOY/EOY$292,176 / $403,049	2021	FIVE ON BLACK, INC. 401(K) PLAN & TRUST - Plan #001	18 / 25	$292,176 / $403,049
2020	Plan NameFIVE ON BLACK, INC. 401(K) PLAN & TRUST Plan #001 Participants BOY/EOY16 / 18 Assets BOY/EOY$197,380 / $292,176	2020	FIVE ON BLACK, INC. 401(K) PLAN & TRUST - Plan #001	16 / 18	$197,380 / $292,176
2019	Plan NameFIVE ON BLACK, INC. 401(K) PLAN & TRUST Plan #001 Participants BOY/EOY15 / 15 Assets BOY/EOY$130,648 / $197,380	2019	FIVE ON BLACK, INC. 401(K) PLAN & TRUST - Plan #001	15 / 15	$130,648 / $197,380