FORM 1023-EZ for QC MS OPEN

Field Data
EIN 81-3309626
Case Number EO-2017093-000158
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name QC MS OPEN
Organization’s Mailing Address 13 SILVERSTONE DRIVE
City LE CLAIRE
State IA
ZIP 52753-2500
Accounting period End 12
Primary contact name DENNIS M FISHER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DENNIS FISHER
PRESIDENT
13 SILVERSTONE DRIVE
LE CLAIRE IA 52753-2500

Officer/Director/Trustee Two

AMY BEHNKE
TREASURER
1410 JONES STREET
LE CLAIRE IA 52753

Officer/Director/Trustee Three

MEGAN WENTLAND
SECRETARY
1196 FOX HOLLOW LANE
LE CLAIRE IA 52753

Officer/Director/Trustee Four

JAN TREFTZ-ALLEN
HONORARY BOARD MEMBER
505 SOUTH 8TH STREET
ELDRIDGE IA 52748

Organization’s website
Organization’s email DFISHER195371@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/6/2017
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H99 - Medical Research N.E.C.
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 Yes
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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