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  5. Hazelden Foundation

Hazelden Foundation

Headquarter

Company Details

Name: Hazelden Foundation
Jurisdiction: Minnesota
Legal type: Assumed Name
Status: Inactive
Date formed: 26 Feb 2014 (11 years ago)
Company Number: f4527933-289f-e311-97ba-001ec94ffe7f
File Number: 737740300026
Principal Place of Business Address: 15251 Pleasant Valley Road, Center City, MN 55012, USA
ZIP code: 55012
County: Chisago County
Place of Formation: Minnesota

Links between entities

Type Company Name Company Number State
Headquarter of Hazelden Foundation, ILLINOIS CORP_57116633 ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
THE HAZELDEN FOUNDATION WELFARE PLAN 2013 410682405 2014-07-29 HAZELDEN FOUNDATION 1189
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2007-01-01
Business code 621420
Sponsor’s telephone number 6512134900
Plan sponsor’s mailing address PO BOX 11, CENTER CITY, MN, 55012
Plan sponsor’s address 15251 PLEASANT VALLEY ROAD, CENTER CITY, MN, 55012

Number of participants as of the end of the plan year
Active participants 1278
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0

Signature of
Role Plan administrator
Date 2014-07-29
Name of individual signing JAMES BLAHA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-29
Name of individual signing JAMES BLAHA
Valid signature Filed with authorized/valid electronic signature
HAZELDEN FOUNDATION RETIREMENT SAVINGS PLAN 2013 410682405 2014-07-29 HAZELDEN FOUNDATION 1460
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1971-06-01
Business code 813000
Sponsor’s telephone number 6512134529
Plan sponsor’s mailing address 15251 PLEASANT VALLEY ROAD, BC 16, CENTER CITY, MN, 55012
Plan sponsor’s address 15251 PLEASANT VALLEY ROAD, BC 16, CENTER CITY, MN, 55012

Number of participants as of the end of the plan year
Active participants 1280
Retired or separated participants receiving benefits 4
Other retired or separated participants entitled to future benefits 227
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 11
Number of participants with account balances as of the end of the plan year 1316
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 35

Signature of
Role Plan administrator
Date 2014-07-29
Name of individual signing JAMES BLAHA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-29
Name of individual signing JAMES BLAHA
Valid signature Filed with authorized/valid electronic signature
THE HAZELDEN FOUNDATION WELFARE PLAN 2012 410682405 2013-07-25 HAZELDEN FOUNDATION 1132
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2007-01-01
Business code 621420
Sponsor’s telephone number 6512134900
Plan sponsor’s mailing address PO BOX 11, CENTER CITY, MN, 55012
Plan sponsor’s address 15251 PLEASANT VALLEY ROAD, CENTER CITY, MN, 55012

Number of participants as of the end of the plan year
Active participants 1189
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2013-07-25
Name of individual signing JAMES BLAHA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-25
Name of individual signing JAMES BLAHA
Valid signature Filed with authorized/valid electronic signature
THE HAZELDEN FOUNDATION WELFARE PLAN 2011 410682405 2012-07-24 HAZELDEN FOUNDATION 1063
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2007-01-01
Business code 621420
Sponsor’s telephone number 6512134900
Plan sponsor’s mailing address PO BOX 11, CENTER CITY, MN, 55012
Plan sponsor’s address 15251 PLEASANT VALLEY ROAD, CENTER CITY, MN, 55012

Plan administrator’s name and address
Administrator’s EIN 410682405
Plan administrator’s name HAZELDEN FOUNDATION
Plan administrator’s address PO BOX 11, CENTER CITY, MN, 55012
Administrator’s telephone number 6512134900

Number of participants as of the end of the plan year
Active participants 1132
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2012-07-24
Name of individual signing JAMES BLAHA
Valid signature Filed with authorized/valid electronic signature
THE HAZELDEN FOUNDATION WELFARE PLAN 2010 410682405 2011-07-26 HAZELDEN FOUNDATION 1006
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2007-01-01
Business code 621420
Sponsor’s telephone number 6512134900
Plan sponsor’s mailing address PO BOX 11, CENTER CITY, MN, 55012
Plan sponsor’s address 15251 PLEASANT VALLEY ROAD, CENTER CITY, MN, 55012

Plan administrator’s name and address
Administrator’s EIN 410682405
Plan administrator’s name HAZELDEN FOUNDATION
Plan administrator’s address PO BOX 11, CENTER CITY, MN, 55012
Administrator’s telephone number 6512134900

Number of participants as of the end of the plan year
Active participants 1063
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2011-07-25
Name of individual signing JAMES BLAHA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-22
Name of individual signing JAMES BLAHA
Valid signature Filed with authorized/valid electronic signature
THE HAZELDEN FOUNDATION WELFARE PLAN 2009 410682405 2010-07-20 HAZELDEN FOUNDATION 1037
Three-digit plan number (PN) 501
Effective date of plan 2007-01-01
Business code 621420
Sponsor’s telephone number 6512134900
Plan sponsor’s mailing address PO BOX 11, CENTER CITY, MN, 55012
Plan sponsor’s address PO BOX 11, CENTER CITY, MN, 55012

Plan administrator’s name and address
Administrator’s EIN 410682405
Plan administrator’s name HAZELDEN FOUNDATION
Plan administrator’s address PO BOX 11, CENTER CITY, MN, 55012
Administrator’s telephone number 6512134900

Number of participants as of the end of the plan year
Active participants 1006
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of
Role Employer/plan sponsor
Date 2010-07-20
Name of individual signing JAMES BLAHA
Valid signature Filed with authorized/valid electronic signature
THE HAZELDEN FOUNDATION WELFARE PLAN 2009 410682405 2010-07-21 HAZELDEN FOUNDATION 1037
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2007-01-01
Business code 621420
Sponsor’s telephone number 6512134900
Plan sponsor’s mailing address PO BOX 11, CENTER CITY, MN, 55012
Plan sponsor’s address PO BOX 11, CENTER CITY, MN, 55012

Plan administrator’s name and address
Administrator’s EIN 410682405
Plan administrator’s name HAZELDEN FOUNDATION
Plan administrator’s address PO BOX 11, CENTER CITY, MN, 55012
Administrator’s telephone number 6512134900

Number of participants as of the end of the plan year
Active participants 1006
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2010-07-21
Name of individual signing JAMES BLAHA
Valid signature Filed with authorized/valid electronic signature

Aplicant

Name Role Address
Hazelden Betty Ford Foundation Aplicant 15251 Pleasant Valley Road, Center City, MN 55012

Filing

Filing Name Filing date
Administrative Expiration - Assumed Name 2024-02-23
Original Filing - Assumed Name (Business Name: Hazelden Foundation ) 2014-02-26

Related by officers

Hazelden Betty Ford Foundation

Hazelden Publishing Hazelden Publishing Hazelden Betty Ford Graduate School Hazelden

Related by address

No related companies by address

Date of last update: 25 Sep 2024

Sources: Minnesota's Official State Website

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