FORM 1023-EZ for QMI

Field Data
EIN 46-4035659
Case Number EO-2017237-000262
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name QMI
Organization’s Mailing Address 612 OBISPO AVE
City LONG BEACH
State CA
ZIP 90814
Accounting period End 12
Primary contact name MICHAEL ROHRER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARY ROHRER
EXECUTIVE DIRECTOR
13674 SAN ANTONIO AVE
CHINO CA 91710

Officer/Director/Trustee Two

MICHAEL ROHRER
SECRETARY
13674 SAN ANTONIO AVE
CHINO CA 91710

Officer/Director/Trustee Three

FRANK HYSON
CFO
24441 STONEHILL DR
DANA POINT CA 92629

Officer/Director/Trustee Four

LUANN VADASZ
CREATIVE DIRECTOR
6648 CAPERS WAY
CYPRESS CA 90630

Officer/Director/Trustee Five

RUSTY RINEHART
LEGAL
2105 S BASCOM AVE SUITE 360
CAMPBELL CA 95008

Organization’s website WWW.QMI.CARE
Organization’s email MIKE.ROHRER@QMI.CARE
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/16/2013
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S11 - Single Organization Support
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date
EIN 46-4035659
Case Number EO-2015071-000915
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name QMI
Organization’s Mailing Address 612 OBISPO AVE
City LONG BEACH
State CA
ZIP 90814
Accounting period End 12
Primary contact name MICHAEL ROHRER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARY ROHRER
EXECUTIVE DIRECTOR
13674 SAN ANTONIO AVE
CHINO CA 91710

Officer/Director/Trustee Two

MICHAEL ROHRER
SECRETARY
13674 SAN ANTONIO AVE
CHINO CA 91710

Officer/Director/Trustee Three

FRANK HYSON
CFO
24441 STONEHILL DR
DANA POINT CA 92629

Officer/Director/Trustee Four

LUANN VADASZ
CREATIVE DIRECTOR
6648 CAPERS WAY
CYPRESS CA 90630

Officer/Director/Trustee Five

RUSTY RINEHART
GENERAL COUNSEL
2105 S BASCOM AVE 340
CAMPBELL CA 95008

Organization’s website WWW.QMI.CARE
Organization’s email MIKE.ROHRER@QMI.CARE
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/16/2013
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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