2023-11-15T20:26:26-06:00 2022-12-31 Foundation Source 3333 New Hyde Park Rd Ste 406 New Hyde Park NY 11042 990PF 2022-01-01 261580196 The Passport Foundation % Foundation Source PASS 8008391754 Foundation Source 501 Silverside Rd Wilmington DE 198091377 John Burbank PRESIDENT 8008391754 2023-11-15 true John Burbank 999009999 Jeffrey D Haskell P01345770 8008391754 2022 2023-04-26 12:10:37Z X 77342418 X 4059106 2525 2525 3495961 7367833 4274184 128484 123219 7686076 4399928 0 158122 158122 5409 0 0 5409 126776 0 0 126776 82000 82000 2073 2073 102766 1066 256 256 33715 36 33679 98 98 1483213 1340252 135684 1994428 1343427 0 542024 3889862 3889862 5884290 1343427 0 4431886 1801786 3056501 5986597 96658 96658 294861 161994 294861 294861 48686 48686 48686 702398 40635959 48848529 76902213 47486948 49288734 77342418 0 0 X 47486948 49288734 47486948 49288734 47486948 49288734 47486948 1801786 49288734 49288734 Publicly-traded Securities 2523690 1003483 1520207 1520207 Passthrough K1 Capital Gain/(Loss) -418829 AVENTUS D 2022-04-30 35503 50826 -15323 -15323 AVENTUS D 2022-05-04 151841 221164 -69323 -69323 DATAMINR INC. P 2015-03-02 2022-12-16 565383 364994 200389 200389 DISTRIBUTED GLOBAL OFFSHORE FUND II LTD P 2018-02-28 2022-09-29 1066 246 820 820 DISTRIBUTED GLOBAL OFFSHORE FUND II LTD P 2018-02-28 2022-12-15 86980 34107 52873 52873 SPHERA BIOTECH FEEDER FUND, L.P P 2021-03-01 2022-07-15 505531 1000000 -494469 -494469 OFFSHORE HEDGE FUND CAPITAL GAIN DISTRIBUTIONS 3497839 3497839 3497839 4274184 42485 42485 42485 104668 0 104668 X 0 62183 62183 false false false false false true true false true true CA true false false false false true Foundation Source 8008391754 501 Silverside Road Suite 123 Wilmington DE 198091377 false false false false true false false false false false false false false false false false true false false true false false false false Ani Arutyunyan Foundation Source 501 Silverside Rd Wilmington DE 198091377 Sec 1.0 0 0 0 John H Burbank III Foundation Source 501 Silverside Rd Wilmington DE 198091377 Dir, Pres 1.0 0 0 0 Jim Cunningham Foundation Source 501 Silverside Rd Wilmington DE 198091377 Dir, Trustee 1.0 0 0 0 Walther Lovato Foundation Source 501 Silverside Rd Wilmington DE 198091377 Dir 1.0 0 0 0 Joanne Poile Foundation Source 501 Silverside Rd Wilmington DE 198091377 Treas 1.0 0 0 0 WILLIAM WALSH FOUNDATION SOURCE WILMINGTON DE 198091377 EXECUTIVE DIRECTOR 40.0 158122 Foundation Source 55 Walls Drive 3rd Fl Fairfield CT 06824 Administrative 124288 Janet Maughan 428 Lagunitas Avenue Oakland CA 94610 Philanthropic 82000 Navolio & Tallman LLP 2121 N California Blvd Suite 610 Walnut Creek CA 94596 Accounting 75000 Susan Chen 277 Elder View Drive Las Vegas NV 89138 Accounting 51776 1093085 1772263 77482593 80347941 0 80347941 1205219 79142722 3957136 3957136 42485 42485 3914651 3914651 3914651 4431886 0 0 0 0 4431886 3914651 4316040 2020 2019 2018 4431886 4316040 115846 0 0 3798805 0 0 John H Burbank III X ACLU FOUNDATION OF SOUTHERN CALIFORNIA 1313 WEST EIGHTH ST LOS ANGELES CA 90017 N/A PC Employee Matching 1000 ADELANTE FOUNDATION 37 UPENUF RD WOODSIDE CA 94062 N/A PC Employee Matching 500 BLACK WOMEN FOR WELLNESS PO BOX 292516 LOS ANGELES CA 90029 N/A PC Celebrating Black Beauty and Building a Movement to transform the toxic beauty industry 60000 BLUEGREEN ALLIANCE FOUNDATION 2701 UNIVERSITY AVE SE STE 209 MINNEAPOLIS MN 55414 N/A PC Scaling up the use of alternative assessment and safer chemical frameworks to limit the production and use of hazardous substances, grow the market for safer materials and promote technological innovation 35000 BRATTLEBORO AREA HOSPICE 191 CANAL ST BRATTLEBORO VT 05301 N/A PC Employee Matching 150 BREAST CANCER PREVENTION PARTNERS 1388 SUTTER ST STE 400 SAN FRANCISCO CA 94109 N/A PC Creating Hazard Profiles - IFRA List 30000 BREAST CANCER PREVENTION PARTNERS 1388 SUTTER ST STE 400 SAN FRANCISCO CA 94109 N/A PC BCPP's work on beauty and personal care product safety 75000 BREAST CANCER PREVENTION PARTNERS 1388 SUTTER ST STE 400 SAN FRANCISCO CA 94109 N/A PC Clearya Grant Renewal 2022 100000 BRIGID ALLIANCE INC PO BOX 58 NEW YORK NY 10024 N/A PC Employee Matching 200 CENTER FOR ENVIRONMENTAL HEALTH 2201 BROADWAY STE 508 OAKLAND CA 94612 N/A PC General Support 80000 CENTER FOR ENVIRONMENTAL HEALTH 2201 BROADWAY STE 508 OAKLAND CA 94612 N/A PC Because Health Transition 50000 CENTER FOR INTERNATIONAL ENVIRONMENTAL LAW INC 1101 15TH ST NW 11TH FLOOR WASHINGTON DC 20005 N/A PC General Support - Environmental Health Program 80000 CENTER FOR SCIENCE IN THE PUBLIC INTEREST 1250 I ST NW STE 500 WASHINGTON DC 20005 N/A PC Reducing Harmful Chemicals and Heavy Metals in Foods 100000 CHANGE ORG CHARITABLE FOUNDATION INC 548 MARKET ST BOX 29993 SAN FRANCISCO CA 94104 N/A PC General & Unrestricted 780 CHESAPEAKE BAY FOUNDATION INC 6 HERNDON AVE ANNAPOLIS MD 21403 N/A PC Employee Matching 450 CHILDREN OF ARMENIA FUND INC 149 5TH AVE STE 500 NEW YORK NY 10010 N/A PC Employee Matching 10000 CHILDRENS ENVIRONMENTAL HEALTH NETWORK 110 MARYLAND AVE NE WASHINGTON DC 20002 N/A PC Cancer Free Economy (CFE) Network-AACR Conference on environmental carcinogenesis 80000 CLEAN AND HEALTHY NEW YORK INC 69 STATE ST SUITE 1400C ALBANY NY 12207 N/A PC Advancing a Nontoxic, Just, Regenerative Circular economy 65000 COMING CLEAN INC 28 VERNON ST STE 434 BRATTLEBORO VT 05301 N/A PC Employee Matching 126 COMING CLEAN INC 28 VERNON ST STE 434 BRATTLEBORO VT 05301 N/A PC Campaign for Healthier Solutions 75000 DATAKIND 271 CADMAN PLZ E UNIT 24554 BROOKLYN NY 11202 N/A PC EJ Database - Pharos API 35000 DEFEND OUR HEALTH 565 CONGRESS ST STE 204 PORTLAND ME 04101 N/A PC The Health Burden of Plastics 100000 EARTHJUSTICE 50 CALIFORNIA ST SUITE 500 SAN FRANCISCO CA 94111 N/A PC Safeguarding Our Health: Protecting our Communities from toxics and fighting chemical secrecy 250000 EARTHJUSTICE 50 CALIFORNIA ST SUITE 500 SAN FRANCISCO CA 94111 N/A PC General & Unrestricted 5000 EDGEWOOD CENTER FOR CHILDREN AND FAMILIES 1801 VICENTE ST SAN FRANCISCO CA 94116 N/A PC Employee Matching 1000 ELEVATOR 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THE UNITED STATES 2000 PENNSYLVANIA AVE SUITE 500 WASHINGTON DC 20006 N/A PC Project TENDR (Targeting Nuero-Developmental Risks) 60000 THE COMMUNITY FOUNDATION INC 3409 MOORE ST RICHMOND VA 23230 N/A PC Fund for River Counties 200 THE REGENTS OF THE UNIVERSITY OF CALIFORNIA AT SAN PO BOX 45339 SAN FRANCISCO CA 94145 N/A PC Defending Science and Promoting Evidence-Based Decision making about toxic environmental chemicals 125000 TOXIC-FREE FUTURE 4649 SUNNYSIDE AVE N STE 540 SEATTLE WA 98103 N/A PC Safer States Chemical and Plastics Campaigns 75000 TOXIC-FREE FUTURE 4649 SUNNYSIDE AVE N STE 540 SEATTLE WA 98103 N/A PC Safer Chemicals Healthy Families/ Mind the Store 250000 TOXIC-FREE FUTURE 4649 SUNNYSIDE AVE N STE 540 SEATTLE WA 98103 N/A PC General & Unrestricted 250000 TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW 516 WEST 168TH ST 3RD FL NEW YORK NY 10032 N/A PC Building a multi-racial and intersectional movement to reduce toxic chemical use in beauty and personal care products 50000 VIRGINIA ORGANIZING INC 703 CONCORD AVE CHARLOTTESVILLE VA 22903 N/A PC HEFN 2.0: Toxics Funders Expansion Project 50000 VIRGINIA ORGANIZING INC 703 CONCORD AVE CHARLOTTESVILLE VA 22903 N/A PC Healthy Baby Food for All Babies 60000 WIKIMEDIA FOUNDATION INC PO BOX 98204 WASHINGTON DC 20090 N/A PC Employee Matching 104 WOMENS DAYTIME DROP-IN CENTER 2218 ACTON ST BERKELEY CA 94702 N/A PC Employee Matching 2500 WOMENS VOICES FOR THE EARTH PO BOX 8743 MISSOULA MT 59807 N/A PC Determining Health Risks in CA Nail & Hair Salons 65000 YOUNG MENS CHRISTIAN ASSOCIATION OF GREATER LONG B 3605 LONG BEACH BLVD LONG BEACH CA 90807 N/A PC Employee Matching 150 YOUNG PEOPLES CHORUS OF NEW YORK CITY INC 37 W 65TH ST 2ND FL NEW YORK NY 10023 N/A PC Employee Matching 100 3889862 14 2525 18 3495961 K-1 Inc/Loss 525990 -1 14 114363 Federal Tax Refund 01 1172 INTEREST FROM PARTNERSHIPS 14 12950 -1 3626971 3626970 false false false false false false false false false false X X 1 Burbank III John H 122 W Dilido Dr Miami Beach FL 33139 4059106 X X 1 ATAI LIFE SCIENCES N.V ATAI, 175165 sh. 909106 2022-02-07 Audit Fees 126776 126776 INTERNATIONAL POLLUTANTS ELIMINATION NET BOX 7256 GOTHENBURG SW 40235 2020-06-02 75000 SUPPORT LEVERAGING DATA ON TOXIC CHEMICALS IN PLASTICS TO ADVANCE ENVIRONMENTAL HEALTH GOALS 75000 NO 08/30/2021, 5/25/2022, 3/28/2023 NONE NECESSARY INTERNATIONAL POLLUTANTS ELIMINATION NET BOX 7256 GOTHENBURG SW 40235 2022-07-02 100000 support leveraging the treaty process to advance environmental health goals 81821 NO 3/28/2023 none necessary FORM 926 FORM 926 The Foundation has prepared this form to the best of its ability based on the limited information provided to it by the investment on which the Foundation is reporting and on the basis of having received no information to the contrary. Any missing or incomplete information is due to the Foundation's inability to obtain such information and is not a willful attempt to withhold such information. FORM 8865 FORM 8865 The Foundation has prepared this form to the best of its ability based on the limited information provided to it by the investment on which the Foundation is reporting and on the basis of having received no information to the contrary. 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NONE INVESTMENT CASH 0 48686 Philanthropic Consulting Srvcs 82000 82000 990-PF Estimated Tax for 2022 101700 Foreign Tax Paid 1066 1066