0001683144-16-000001.txt : 20160902 0001683144-16-000001.hdr.sgml : 20160902 20160901184751 ACCESSION NUMBER: 0001683144-16-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20160902 DATE AS OF CHANGE: 20160901 EFFECTIVENESS DATE: 20160902 FILER: COMPANY DATA: COMPANY CONFORMED NAME: QBIS Insurance Solutions, Inc. CENTRAL INDEX KEY: 0001683144 IRS NUMBER: 811923379 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-270021 FILM NUMBER: 161866728 BUSINESS ADDRESS: STREET 1: 344 20TH STREET, #310 CITY: OAKLAND STATE: CA ZIP: 94612 BUSINESS PHONE: 844-327-7247 MAIL ADDRESS: STREET 1: 344 20TH STREET, #310 CITY: OAKLAND STATE: CA ZIP: 94612 D 1 primary_doc.xml X0707 D LIVE 0001683144 QBIS Insurance Solutions, Inc. 344 20TH STREET, #310 OAKLAND CA CALIFORNIA 94612 844-327-7247 DELAWARE None None Corporation true 2016 Gregory P. Morris 344 20TH STREET #310 OAKLAND CA CALIFORNIA 94612 Executive Officer Director Edward W. Igoe 344 20TH STREET #310 OAKLAND CA CALIFORNIA 94612 Executive Officer Director Priya Cherian Huskins 344 20TH STREET #310 OAKLAND CA CALIFORNIA 94612 Director F. Michael Heffernan 344 20TH STREET #310 OAKLAND CA CALIFORNIA 94612 Director Other Technology Decline to Disclose 06b false 2016-08-19 false true false 0 3000000 3000000 0 false 3 0 true 0 true 0 true false QBIS Insurance Solutions, Inc. /s/ Gregory P. Morris Gregory P. Morris President and CEO 2016-09-01