| Plan Name | TATE STREET COFFEE HOUSE RETIREMENT PLAN |
| Plan identification number | 001 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
|
| Company Name: | BLACK CAT COFFEE HOUSE, INC. |
| Employer identification number (EIN): | 561843574 |
| NAIC Classification: | 722300 |
| NAIC Description: | Special Food Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 001 | 2012-01-01 | W. LUTHER PIERCE | 2012-04-24 | ||
| 001 | 2011-01-01 | W. LUTHER PIERCE | 2012-03-20 | ||
| 001 | 2010-01-01 | W. LUTHER PIERCE | 2011-09-12 |