FORM 1023-EZ for QUALITY INDEPENDENT HOME LIFE INC

Field Data
EIN 85-2565179
Case Number EO-2021076-000394
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name QUALITY INDEPENDENT HOME LIFE INC
Organization’s Mailing Address 8318 CALLEGHAN ROAD
City LITTLE ROCK
State AR
ZIP 72210
Accounting period End 11
Primary contact name JAZMINE SMITH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAZMINE SMITH
PRESIDENT/CHAIR
8318 CALLEGHAN ROAD
LITTLE ROCK AR 72210

Officer/Director/Trustee Two

KATHERINE SMIH
VICE PRESIDENT/VICE CHAIR
8318 CALLEGHAN ROAD
LITTLE ROCK AR 72210

Officer/Director/Trustee Three

CARLEISHA CUSTIS
SECRETARY
8318 CALLEGHAN ROAD
LITTLE ROCK AR 72210

Officer/Director/Trustee Four

JAMAAL SMITH
TREASURER
8318 CALLEGHAN ROAD
LITTLE ROCK AR 72210

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/5/2020
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F33 - Group Home, Residential Treatment Facility - Mental Health Related
Organization’s purpose Charitable: No
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JAZMINE SMITH
Signature Title PRESIDENT/CHAIR
Signature Date 1/20/2021

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