Program Questions:
Excelsior Jobs Program

Q_41

Does this project predominantly involve any of the following activities at the project location, and will it meet the minimum job creation requirements OR the minimum job retention requirements in NYS? Please click on "Scoring Tips" for project activity definitions.

(1) Manufacturing: minimum job creation = 5 net new jobs, OR minimum job retention = 5.

(2) Scientific research and development: minimum job creation = 5 net new jobs, OR minimum job retention = 25.

(3) Software development: minimum job creation = 5 net new jobs, OR minimum job retention = 25.

(4) Agricultural production or support; minimum job creation = 5 net new jobs, OR minimum job retention = 25.

(5) Back office operation: minimum job creation = 25 net new jobs, OR minimum job retention = 25.

(6) Financial Services: minimum job creation = 25 net new jobs, OR minimum job retention = 25.

(7) Distribution center: minimum job creation = 50 net new jobs, OR minimum job retention = 25.

(8) Life Sciences: minimum job creation = 5 net new jobs, OR minimum job retention = 25.

(9) Music production: minimum job creation = 5 net new jobs, OR minimum job retention = 25.

(10) Entertainment company: minimum job creation = 100 net new jobs, OR minimum job retention = 25.

Q_1856

Are you a not-for-profit, municipality or public benefit corporation?

Q_928

Project Street Address: Please input the project street address (Street Number and Street Name only).

If the project has multiple locations, please input the primary street address of the project. If the project does not have a definite street address, please input the approximate street address of the project (Street Number and Street Name only).

Q_565

Project City

Q_568

Project State
  • AA,AL,AK,AZ,AR,CA,CO,CT,DE,FL,GA,HI,ID,IL,IN,IA,KS,KY,LA,ME,MD,MA,MI,MN,MS,MO,MT,NE,NV,NH,NJ,NM,NY,NC,ND,OH,OK,OR,PA,RI,SC,SD,TN,TX,UT,VT,VA,WA,WV,WI,WY,AS,DC,FM,GU,MH,MP,PW,PR,VI

Q_572

Project Latitude (This questions value will be filled automatically, based on the project address, when the application is finalized.)

Q_573

Project Longitude (This questions value will be filled automatically, based on the project address, when the application is finalized.)

Q_1034

Project ZIP Code. (please use ZIP+4 if known)

Q_3527

US Congressional District where the project is located.
  • 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27

Q_972

Project county or counties.

Q_971

Project Without a Street Address: please enter a description of the project location. Include project starting/ending street addresses, cities & zip codes if applicable.

Q_184

NYS Assembly District where the project is located. (This questions value will be filled automatically, based on the project address, when the application is finalized.)

Q_190

NY Senate District where the project is located. (This questions value will be filled automatically, based on the project address, when the application is finalized.)

Q_550

If you are a DBA, what is your DBA name?

Q_556

Select an applicant ID type from the list below that you normally use to identify your organization on application forms.
  • Charity Reg #, Duns Number, Federal Tax ID Number, NYS Unemployment Insurance Tax Number, Social Security Number, NYS Vendor Identification Number (SFS)

Q_551

Applicant Street Address

Q_552

Applicant City

Q_553

Applicant State

Q_554

Applicant ZIP Code. (please use ZIP+4 if known)

Q_651

Applicant Telephone Number, (please include area code)

Q_555

Applicant Email Address

Q_547

Contact First Name

Q_1049

Contact Last Name

Q_1050

Contact Title

Q_562

Primary Contact Phone Number. (please include area code)

Q_1052

Additional Project Contact First Name

Q_970

Additional Project Contact Last Name

Q_1051

Additional Contact Title

Q_561

Additional Contact Email Address

Q_930

Explain what makes your project a regional economic priority - for example creates jobs, economic investment, sustainability and community revitalization, government efficiency or consolidation etc.

Q_929

Current State of Project Development (i.e. planning, preliminary engineering, final design, etc. You may enter N/A for non-project related applications)

Q_975

Estimated Project Timeline: including project start/completion dates, estimates for design, permitting and construction or other major steps. (You may enter N/A for non-Project related applications)

Q_580

Provide a list of all federal, state, and local reviews, approvals, or permits needed or completed, including the dates when they are expected to be completed or were completed. If Not Applicable, indicate "NA".

Q_549

Type of Applicant (select all that apply)
  • Federal, State, County, City, Town, Village, Tribal, School District, County or Town Improvement District, District Corporation, For-Profit, Not-For-Profit, Individual, S Corporation, C Corporation, IDA, LDC,LLC,LLP, Public Authority, Public Benefit Corp, Sole-Proprietorship. HDFC,BID, LP,Boards Of Cooperative Educational Services (BOCES), Fire District, Regional Planning and Development Board, Public Library, Association Library,College/University/Community College

Q_546

Legal Name of Applicant

Q_3688

Contact Street Address

Q_3689

Contact City

Q_3690

Contact State

Q_3691

Contact ZIP Code

Q_3692

Contact Email

Q_3693

Additional Contact Street Address

Q_3694

Additional Contact City

Q_3695

Additional Contact State

Q_3696

Additional Contact ZIP Code

Q_3697

Additional Contact Telephone Number

Q_4199

Please select the primary sector or characterization that best defines this project.
  • Agriculture, Arts/Culture/Cultural Institutions, Biomedical/Medical, Community Development, Education/College/University, Energy, Environment, Financial Services, Food/Beverage, Healthcare, Hospitality, Housing, Industrial/Manufacturing, Information Technology Services/Communications, Infrastructure, Municipal/Government, Office, Research & Development, Tourism/Travel, Transportation, Water/Wastewater/Sewer, Waterfront Revitalization, Workforce Development,Business Development,Technology Commercialization

Q_4198

Please select the secondary sector or characterization that best defines this project.
  • Agriculture, Arts/Culture/Cultural Institutions, Biomedical/Medical, Community Development, Education/College/University, Energy, Environment, Financial Services, Food/Beverage, Healthcare, Hospitality, Housing, Industrial/Manufacturing, Information Technology Services/Communications, Infrastructure, Municipal/Government, Office, Research & Development, Tourism/Travel, Transportation, Water/Wastewater/Sewer, Waterfront Revitalization, Workforce Development,Business Development,Technology Commercialization

Q_3656

Is the project included in a NY Rising Community Reconstruction Program plan or a NY Rising Countywide Resiliency Plan?

Q_3744

If the project is included in a NY Rising Community Reconstruction Program plan or a NY Rising Countywide Resiliency Plan, please indicate the planning committee name, project name, and location.

Q_3762

Does your project directly address the needs of people in your region who are living in poverty and who seek resources for inclusion in the economic life of New York State?

Q_3763

How does your project seek to apply CFA funds for the purpose of eliminating barriers to skilled employment by poor people in your region, as identified by the Opportunity Agenda? Please describe any efforts to collaborate at the local or regional level (i.e. public, private, labor, philanthropic sectors).

Q_3764

How does your project build workforce development programs, improve physical infrastructure, and/or establish social services that connect people living in poverty in your region with skilled employment, in correspondence with the economic revitalization priorities, distressed community targets, and the industry growth areas identified in the Opportunity Agenda and Strategic Plan?

Q_3766

Is this a Global NY Project?

Q_3768

If this is a Global NY Project, please describe how this project relates to the identified goals of your region’s Global Marketing and Export Strategies as part of the Global NY initiative?

Q_4201

If Yes, please explain how your project impacts the Veterans’ and military families in New York.

Q_6048

Does your project advance downtown revitalization?

Q_6047

If Yes, please detail how it will attract and retain residents, visitors and businesses and transform neighborhoods.

Q_575

Project Description. Concisely describe the project, indicating the location, what will be planned, designed, acquired, and/or constructed, the issues/opportunities to be addressed, and expected outcomes and deliverables. Additional details will be collected later in the application process.

Q_976

Statement of Need

Q_2366

How does your project align with the Regional Economic Development Council’s Strategic Plan/Upstate Revitalization Initiative Plan? (strategic plans are located at https://regionalcouncils.ny.gov/ )

Q_2364

What is the status of State and/or Federal Environmental Review? If review of the project is underway or completed pursuant to the State Environmental Quality Review Act (SEQRA) or National Environmental Policy Act (NEPA), please indicate the lead agency (if applicable).

Q_2362

If funding was awarded in prior CFA rounds, what were the CFA numbers for which funding was awarded? (separate multiple CFA numbers with commas)

Q_6946

Please provide Letters of Support for your project (if applicable). All letters should be scanned into a single PDF file and their total size cannot exceed 10 Megabytes (MB).

Q_5593

Attach 2015 financial documents

For privately owned companies, IDAs, not-for-profits, educational institutions, start-ups, municipalities, or any business or organization other than publicly traded companies, please provide audited or reviewed financials, or compiled financials with signed tax returns, for 2015. For-publicly traded companies, please provide Form 10-K for 2015.

Q_6907

Attach 2016 financial documents.

For privately owned companies, IDAs, not-for-profits, educational institutions, start-ups, municipalities, or any business or organization other than publicly traded companies, please provide audited or reviewed financials, or compiled financials with signed tax returns, for 2016. For publicly traded companies please provide Form 10-K for 2016.

Q_6906

Attach 2017 financial documents

For privately owned companies, IDAs, not-for-profits, educational institutions, start-ups, municipalities, or any business or organization other than publicly traded companies, please provide audited or reviewed financials, or compiled financials with signed tax returns, for 2017. For-publicly traded companies, please provide Form 10-K for 2017.

Q_6905

Attach interim financials for 2018

For privately owned companies, IDAs, not-for-profits, educational institutions, start-ups, municipalities, or any business or organization other than publicly traded companies, please provide interim financials for 2018, certified by a company officer. For publicly traded companies, please provide the most recent Form 10-Q.

Q_2331

Attach an organizational chart and/or description of ownership structure including the percentage of ownership for each individual entity.

Q_2333

If review of the project has been completed pursuant to State Environmental Quality Review Act (SEQRA) or National Environmental Policy Act (NEPA), please submit the Negative Declaration or Findings Statement, or Finding of No Significant Impact or Record of Decision.

Q_2332

Attach a short or long Environmental Assessment Form

Project review pursuant to the State Environmental Quality Review Act (SEQRA) must be completed prior to the award of any state funds. For projects classified as Type I or Unlisted actions, submit a short or long Environmental Assessment Form. See "View Help" for links to forms.

Q_3064

Net New Job Information (Enter Cumulatively) 1. Enter the type of job by general category.
2. Enter the gross annual wages for each job type.
3. List the number of net new jobs. Please enter CUMULATIVE job totals, i.e. if there are 10 jobs being created each year for 5 years, enter as 10, 20, 30, 40, 50.

Please note that if you are completing the URI Phase 1 - Intent to Propose, you are not required to complete the table below at this time as this information will be available to enter in during phase 2 of the application.

Q_1339

Applicant website

Q_740

What is the applicant's Federal Tax ID#?

Q_595

Indicate the principal North American Industrial Classification System (NAICS) Code of the Company.

Q_1142

Indicate the Primary North American Industrial Classification System (NAICS) Code associated with the activity of the business at the project location.

Q_1075

Describe the ownership of the applicant’s business including, if applicable, the names of principal owners:

Q_1076

Identify the applicant’s parent and subsidiary companies (if none, please respond with N/A):

Q_900

Electric Utility Company Name

Q_902

Natural Gas Utility Company Name

Q_2221

Is the applicant an Empire Zone certified entity? If so, please provide the Empire Zone address location.

Q_3134

Is a third party being used to complete this application such as consultant, accountant or attorney?

Q_3136

If you are a third party completing this application you must disclose your name, company and contact information.

Q_1410

Briefly describe what the project involves in terms of product(s) or services(s) that will be provided at the project location.

Q_1224

Have any expenditures for the project been made prior to the date of this application? If yes, explain.

Q_3006

Qualified Investments

Q_3017

Qualified Investments Building Acquisition

Q_3030

Qualified Investments Building Acquisition

Q_3042

Qualified Investments Building Acquisition

Q_3007

Qualified Investments Year 1

Q_3008

Qualified Investments Year 1

Q_3009

Qualified Investments Year 1

Q_3010

Qualified Investments Year 1

Q_3012

Qualified Investments Year 1

Q_3014

Qualified Investments Year 1

Q_3015

Qualified Investments Year 1

Q_3018

Qualified Investments Building Renovation Year 2

Q_3019

Qualified Investments New Construction Year 2

Q_3020

Qualified Investments Production Machinery Year 2

Q_3022

Qualified Investments Furniture, fixtures Year 2

Q_3024

Qualified Investments Land Acquisition * Year 2

Q_3027

Qualified Investments Demolition Year 2

Q_3028

Qualified Investments Year 2

Q_3031

Qualified Investments Building Renovation Year 3

Q_3032

Qualified Investments New Construction Year 3

Q_3033

Qualified Investments Production Machinery Year 3

Q_3034

Qualified Investments Furniture, fixtures Year 3

Q_3036

Qualified Investments Land Acquisition * Year 3

Q_3039

Qualified Investments Demolition Year 3

Q_3040

Qualified Investments Year 3

Q_3043

Qualified Investments Building Renovation Year 4

Q_3044

Qualified Investments New Construction Year 4

Q_3045

Qualified Investments Production Machinery Year 4

Q_3046

Qualified Investments Furniture, fixtures Year 4

Q_3048

Qualified Investments Land Acquisition * Year 4

Q_3050

Qualified Investments Demolition Year 4

Q_3051

Qualified Investments Year 4

Q_3053

Qualified Investments Building Acquisition

Q_3054

Qualified Investments Building Renovation Year 5

Q_3055

Qualified Investments New Construction Year 5

Q_3056

Qualified Investments Production Machinery Year 5

Q_3057

Qualified Investments Furniture, fixtures Year 5

Q_3059

Qualified Investments Land Acquisition * Year 5

Q_3061

Qualified Investments Demolition Year 5

Q_3062

Qualified Investments Year 5

Q_2195

Indicate how many existing full-time equivalent jobs the applicant employs in all NYS LOCATIONS.

Q_2199

Indicate the average annual wage for existing full-time equivalent employees the applicant employs in all NYS Locations as of the date this application is finalized.

Q_1365

Indicate how many of the total existing full-time equivalent employees in New York State are contract employees.

Q_2196

Indicate how many existing full-time equivalent jobs the applicant employs at all PROJECT LOCATION(S).

Q_1186

Indicate the average annual wage for the employees at the Project Location as of the date this application is finalized.

Q_1366

Indicate how many of the total existing full-time equivalent employees at the Project Location are contract employees.

Q_1196

How many of the existing jobs at the project location(s) are at risk if the project does not go forward.

Q_1375

What percentage of the project's employees are residents of NYS?

Q_4167

Definition of full-time equivalent employee: (1) a full-time, permanent, private-sector employee on the Recipient's payroll, who has worked at the Project Location for a minimum of 35 hours per week for not less than four consecutive weeks and who is entitled to receive the usual and customary fringe benefits extended by Recipient to other employees with comparable rank and duties; or (ii) two part-time, permanent, private-sector employees on Recipient's payroll, who have worked at the Project Location for a combined minimum of 35 hours per week for not less than four consecutive weeks and who are entitled to receive the usual and customary fringe benefits extended by Recipient to other employees with comparable rank and duties.

For the Excelsior Jobs Program: a full-time permanent employee must be on the payroll for at least six months of a year in order to qualify for benefits. Jobs transferred from employment with another business located in the State including from a related person in this State are not net new jobs for purposes of the employment commitment.

Indicate the year employment begins under Year 1 for your project here:

Q_7506

Indicate how many new full-time equivalent employees (using the definition in the question above) the company will create over 5 years.

If awarded, your company or entity will be held to the job creation commitments as outlined in this question and table below. For grants, should you fail to meet the job creation commitments, recapture provisions may apply. For Excelsior, each years job commitment is evaluated separately to determine if tax credits can be issued.

Q_3065

Net New Job Information

Q_3066

Net New Job Information

Q_3067

Net New Job Information

Q_3068

Net New Job Information

Q_3069

Net New Job Information

Q_3070

Net New Job Information

Q_3071

Net New Job Information Job Type/Category

Q_3072

Net New Job Information 2 Avg Gross Wages/Job Type

Q_3073

Net New Job Information 2 Year 1 -

Q_3074

Net New Job Information 2 Year 2 -

Q_3075

Net New Job Information 2 Year 3 -

Q_3076

Net New Job Information 2 Year 4 -

Q_3077

Net New Job Information 2 Year 5 -

Q_3078

Net New Job Information (Enter Cumulatively) Job Type/Category

Q_3079

Net New Job Information (Enter Cumulatively) 3 Avg Gross Wages/Job Type

Q_3080

Net New Job Information (Enter Cumulatively) 3 Year 1 -

Q_3081

Net New Job Information (Enter Cumulatively) 3 Year 2 -

Q_3082

Net New Job Information (Enter Cumulatively) 3 Year 3 -

Q_3083

Net New Job Information (Enter Cumulatively) 3 Year 4 -

Q_3084

Net New Job Information (Enter Cumulatively) 3 Year 5 -

Q_3086

Net New Job Information (Enter Cumulatively) Job Type/Category

Q_3089

Net New Job Information (Enter Cumulatively) 4 Avg Gross Wages/Job Type

Q_3090

Net New Job Information (Enter Cumulatively) 4 Year 1 -

Q_3091

Net New Job Information (Enter Cumulatively) 4 Year 2 -

Q_3092

Net New Job Information (Enter Cumulatively) 4 Year 3 -

Q_3093

Net New Job Information (Enter Cumulatively) 4 Year 4 -

Q_3094

Net New Job Information (Enter Cumulatively) 4 Year 5 -

Q_3095

Net New Job Information (Enter Cumulatively) Job Type/Category

Q_3096

Net New Job Information (Enter Cumulatively) 5 Avg Gross Wages/Job Type

Q_3097

Net New Job Information (Enter Cumulatively) 5 Year 1 -

Q_3098

Net New Job Information (Enter Cumulatively) 5 Year 2 -

Q_3099

Net New Job Information (Enter Cumulatively) 5 Year 3 -

Q_3100

Net New Job Information (Enter Cumulatively) 5 Year 4 -

Q_3101

Net New Job Information (Enter Cumulatively) 5 Year 5 -

Q_1415

Indicate what the average percentage is of the applicants' total employees' gross wages paid in benefits (exclude mandated benefits such as Federal Insurance Contributions Act (FICA), Medicare tax, unemployment insurance or workers' compensation insurance.

Q_2372

Will the proposed project result in the creation of construction jobs? If so, estimate the number of construction jobs to be created.

Enter zero if not applicable.

Q_3525

Do you conduct, or plan to conduct, research & development activities at this project location? Indicate Y/N. If "Y", please describe.

Q_3001

Research & Development

Q_3002

Research & Development

Q_3003

Research & Development

Q_3004

Research & Development

Q_3005

Research & Development

Q_3526

Estimate the future annual real property taxes or annual PILOT payments based on the investments in the property. What are the annual savings on real property taxes resulting from a PILOT agreement based on the investments in the property?

Q_1368

Please indicate the current annual real property taxes or PILOT payments.

Q_1367

Does, or will, the applicant own the property(ies) or have a lease specifying that it will pay the property taxes to the taxing jurisdiction for this project location(s)?
  • Yes, No, N/A

Q_1872

Pursuant to section 354(2) of the New York State economic development law: As the preparer of this application, I attest to being an authorized representative of the applicant and, by placing my name in the box below, I hereby: 1. Agree to allow the Department of Taxation and Finance to share tax information with the Department of Economic Development. However, any information shared as a result of this agreement shall not be available for disclosure or inspection under the State Freedom of Information law; 2. Agree to allow the Department of Labor to share tax and employer information with the Department of Economic Development. However, any information shared as a result of this agreement shall not be available for disclosure or inspection under the State Freedom of Information Law; 3. Agree to disqualify for empire zone benefits at any location or locations that qualify for Excelsior Jobs Program benefits if admitted into the excelsior jobs program; 4. Allow the Department and its agents access to any and all books and records the Department of Economic Development may require to monitor compliance; 5. Provide to the Department of Economic Development, upon its request, the information outlined in Section 354 (e) of Article 17 of the Economic Development Law; 6. Provide a clear and detailed presentation of all related persons as defined in subparagraph (c) of paragraph 3 of subsection (b) of section 465 of the Internal Revenue Code to the applicant to assure the Department of Economic Development that the jobs indicated in this application are not being shifted within the State; 7.Certify, under penalty of perjury, that the applicant is in substantial compliance with all environmental, worker protection, and local, state and federal tax laws.

Q_1038

By entering your name in the box below, you certify that you are authorized on behalf of the applicant and its governing body to submit this application. You further certify that all of the information contained in this Application and in all statements, data and supporting documents which have been made or furnished for the purpose of receiving assistance for the project described in this application, are true, correct and complete to the best of your knowledge and belief. You acknowledge that offering a written instrument knowing that the written instrument contains a false statement or false information, with the intent to defraud the State or any political subdivision, public authority or public benefit corporation of the State, with the knowledge or belief that it will be filed with or recorded by the State or any political subdivision, public authority or public benefit corporation of the State, constitutes a crime under New York State Law.

Q_3713

Management

Q_3714

Computer and Mathematical

Q_3715

Production

Q_3716

Community and Social Services

Q_3717

Construction and Extraction

Q_3718

Life, Physical, and Social Science

Q_3719

Healthcare Practitioners and Technical

Q_3720

Installation, Maintenance, and Repair

Q_3721

Building and Grounds Cleaning and Maintenance

Q_3722

Food Preparation and Serving Related

Q_3723

Arts, Design, Entertainment, Sports, and Media

Q_3724

Protective Service

Q_3725

Legal

Q_3726

Sales and Related

Q_3727

Architecture and Engineering

Q_3728

Personal Care and Service

Q_3729

Healthcare Support

Q_3730

Transportation and Material Moving

Q_3731

Farming, Fishing, and Forestry

Q_3732

Business and Financial Operations

Q_3733

Education, Training, and Library

Q_3734

Office and Administrative Support

Q_3735

1st Most Common Recruitment Method
  • None,In-house Recruitment (employee referrals / in-house applicants),Job Posting (company website / NYS DOL / online job boards / newspaper),Social Recruiting (LinkedIn/Twitter/Facebook),Talent Communities,Career Fairs (physical and virtual),Recruiters/Headhunters,NYS Career Center Services,Other (please specify)

Q_3738

1st Most Common Recruitment Method - Other

Q_3741

1st Most Common Recruitment Method - Percentage of Use

Q_3736

2nd Most Common Recruitment Method
  • None,In-house Recruitment (employee referrals / in-house applicants),Job Posting (company website / NYS DOL / online job boards / newspaper),Social Recruiting (LinkedIn/Twitter/Facebook),Talent Communities,Career Fairs (physical and virtual),Recruiters/Headhunters,NYS Career Center Services,Other (please specify)

Q_3739

2nd Most Common Recruitment Method - Other

Q_3742

2nd Most Common Recruitment Method - Percentage of Use

Q_3737

3rd Most Common Recruitment Method
  • None,In-house Recruitment (employee referrals / in-house applicants),Job Posting (company website / NYS DOL / online job boards / newspaper),Social Recruiting (LinkedIn/Twitter/Facebook),Talent Communities,Career Fairs (physical and virtual),Recruiters/Headhunters,NYS Career Center Services,Other (please specify)

Q_3740

3rd Most Common Recruitment Method - Other

Q_3743

3rd Most Common Recruitment Method - Percentage of Use