Does this project meet the qualifications for the Green CHIPS program detailed below?

(1) is within the semiconductor manufacturing and related equipment and material supplier sector;
(2) includes sustainability measures to mitigate the project's greenhouse gas emissions over its lifetime under a Green CHIPS sustainability plan;
(3) provides for the payment of not less than federal prevailing wage rates for its project construction;
(4) makes specific and actionable commitments to worker and community investment under a Green CHIPS community plan;
(5) will create at least five hundred net new jobs and make at least three billion dollars in qualified investment prior to the conclusion of its preliminary schedule of benefits; and
(6) will maintain a Green CHIPS benefit-cost ratio of at least fifteen to one as calculated for the overall project term.

Please see question requirements for further information and a link to the regulations.

US Congressional District where the project is located. (This question's value will be filled automatically, based on the project address, when the application is finalized.)

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).

Project City

Project county or counties.

Project State

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

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

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

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

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

Based on your selection from the previous question, enter the associated ID number.

Applicant First Name

Applicant Last Name

Contact Salutation

Primary Organization

Additional Salutation

Additional Organization

Please indicate the lead agency (if applicable).

Has a National Environmental Policy Act (NEPA) Record of Decision been issued?

Please explain decision and include date of Record of Decision.

Type of Applicant (select one)
Applicants will first select a single applicant type from the categories below and then a subtype based on their initial selection. Applicants should review the selections below which provides a list of subtypes by main applicant type.

1. For Profit entity options:
Limited Liability Corporation (LLC)
Limited Liability Partnership (LLP)
Sole Proprietorship
S Corporation
C Corporation
Limited Partnership (LP)
Other- applicant will be required to list their other for-profit designation.

2. Not-for profit entity options:
501(c)(1) Any corporation that is organized under an act of Congress that is exempt from federal income tax;
501(c)(2) Corporations that hold a title of property for exempt organizations;
501(c)(3) Corporations/funds/foundations that operate for religious/ charitable/ scientific/ literary/ educational purposes;
501(c)(4) Nonprofit organizations that promote social welfare;
501(c)(5) Labor, agricultural, or horticultural associations;
501(c)(6) Business leagues/chambers of commerce/etc. that are not organized for profit;
501(c)(7) Recreational organizations; and
Other- applicant will be required to list their other not-for-profit designation.

3. Government entity options:
Federal
State
County
City
Town
Village
Tribal
School District
County or Town Improvement District
District Corporation
Public Authority
Business Improvement District
Fire District
Board of Cooperative Education Services (BOCES)
Public Library
Association Library
Other- applicant will be required to list their other government designation.

Select the for-profit entity of the applicant applying for funding:

Enter the applicant's 'Other' for-profit entity designation.

Select the not-for-profit entity of the applicant applying for funding:

Enter the applicant's 'Other' not-for-profit entity designation.

Select the government entity of the applicant applying for funding:

Enter the applicant's 'Other' government entity designation.

Is the applicant a DBA?

What is the applicant's DBA name?

Select an applicant ID type from the list below that you normally use to identify your organization on application forms.

Organization Legal Name

Applicant Street Address

Applicant City

Applicant State

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

Applicant Telephone Number (please include area code)

Applicant Email Address

Contact First Name

Contact Last Name

Contact Title

Contact Street Address

Contact City

Contact State

Contact ZIP Code (please use ZIP+4 if known)

Primary Contact Phone Number. (please include area code)

Contact Email

Additional Project Contact First Name

Additional Project Contact Last Name

Additional Contact Title

Additional Contact Street Address

Additional Contact City

Additional Contact State

Additional Contact ZIP (please use ZIP+4 if known)

Additional Contact Telephone Number (please include area code)

Additional Contact Email Address

Please select the primary sector or characterization that best defines this project.

Please select the secondary sector or characterization that best defines this project.

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.

Statement of need: Provide a brief summary of the need for the project in the geographic area proposed and the project's financing needs, including funding gaps of the proposed project.

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

Estimated Project Timeline: include project start/completion dates, estimates for design, permitting and construction or other major steps.

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".

Does this project require State and/or Federal Environmental Review?

What is the status of State and/or Federal Environmental Review?

List all entities and their EIN that the employment is being reported to DOL under.
ALL NYS Locations

List all entities and their EIN that the employment is being reported to DOL under.
Project location only

A. Total Employees / Jobs
(this should add up to the sum of Total Full Time Employees + Total Part Time Employees + Total Contract Employees)

A. Total Employees / Jobs (Project Location Only)
(this should add up to the sum of Total Full Time Employees + Total Part Time Employees + Total Contract Employees)

B. Total Full Time Employees / Jobs Only
All NYS Locations

B. Total Full Time Employees / Jobs Only
Project Location Only

C. Total Part-time Employees/Jobs Only

C. Total Part-time Employees/Jobs Only Project Location Only

D. Total Contract Employees/Jobs Only ALL NYS Locations

D. Total Contract Employees/Jobs Only Project Location Only

E. Total Full Time Equivalents (FTEs)
(this should be calculated from part-time employees only (C) using the FTE definition from the top of the page)
ALL NYS Locations

E. Total Full Time Equivalents (FTEs)
(this should be calculated from part-time employees only (C) using the FTE definition from the top of the page)
Project location only

F. Total Full Time Employees + Total FTEs (B+E) All NYS LOCATIONS.

F. Total Full Time Employees + Total FTEs (B+E) PROJECT LOCATION Only

G. Average Annual Wage (Full Time Employees and FTEs) All NYS Locations as of the date this application is finalized

G. Average Annual Wage (Full Time Employees and FTEs) Project Location Only as of the date this application is finalized.

H. At Risk Positions (From Existing Full Time Employees and FTEs)
How many of the existing jobs at the project location(s) are at risk if the project does not go forward.

I. Average Annual Wage of at Risk Employees/Jobs (Full Time Employees and FTEs)
project location only

J. Percentage of Employees that are residents of New York State
ALL NYS locations

J. Percentage of Employees that are residents of New York State Project Location Only

K. Construction Jobs: Estimate the number of construction jobs to be created by the proposed project.

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.

What percentage of the project’s net-new employees will work remotely (in part or fully)?
If none, then enter 0(zero).

Capital Investment, R&D, and Net New Jobs Commitments:
Using the template provided below please upload the following information:
1. Investment Commitments Tab
a. Capital Investment Commitment: For each category, complete the projected investment schedule by year for each 10-year phase of the project for the investment categories listed. There is a minimum of $3 billion in investments per phase.
b. R&D Investment Commitment: Complete the projected R&D investment schedule by year for each 10-year phase of the project. This should be an estimate of the portion of any Federal research and development tax credits, attributable to research and development activities conducted in New York State, that the applicant anticipates claiming the Excelsior Research and Development Credit. https://www.irs.gov/pub/irs-pdf/i6765.pdf

2. Jobs Commitment Tab
a. Jobs Commitment: Complete the projected net new jobs schedule by year for each 10-year phase of the project by job category. Please include details on job titles and expected gross annual wages for each job type. There is a minimum of 500 jobs per phase.

Upload a detailed narrative corresponding to each section of the prior upload for Capital Investment, R&D, and Jobs Commitments. The document should include 3 sections as described below:

1- A narrative describing the projected investments for each phase of the project in the schedule/budget uploaded.
2- A narrative summarizing the planned Federal research and development investments in the schedule/budget uploaded.
3- A narrative describing the overall plan for meeting the job requirements in the schedule uploaded.

Please attach an approved Sustainability Plan in accordance with the Green CHIPS Sustainability Plan Template below, along with a letter of approval from ESD.

Please attach an approved Community Plan in accordance with the Green CHIPS Community Plan Template below, along with a letter of approval from ESD.

Childcare: Will this project include the applicant undertaking or sponsoring new childcare services for its employees?

Please complete the excel template provided for anticipated childcare capital expenses in the applicable categories by year, as well as anticipated net new childcare services expenses (non-capital) in applicable categories by year. Additionally, please provide a narrative of the childcare capital and non-capital expenses, including the location, hours of operation, and specific services to be provided. Before uploading, zip the word document and excel file together in a single file.

Please note: "Net new child care services expenditures" means the calculation of new, annual participant expenditures on childcare services whether internal or provided by a third party (including coverage for full or partial discount of employee rates), minus any revenues received by the participant through a third-party operator (i.e. rent paid to the participant by the child care provider) or employees and may be further defined by the commissioner in regulations. For the purposes of this definition, expenditures for childcare services that a participant has incurred prior to admission to this program shall not be eligible for the credit.

Attach an organizational chart along with a brief description of the ownership structure. Please specify the ownership of the applicant’s business including the names of principal owners, include the percentage of ownership for each individual entity (if applicable), and if the company is a parent, subsidiary and/or affiliate of another company, please provide a description of the relationship. Additional financial information may be requested.

Attach interim financial documents for 2025

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 2025. For-publicly traded companies, please provide Form 10-K for 2025.

Attach 2024 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 2024. For-publicly traded companies, please provide Form 10-K for 2024.

Attach 2023 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 2023. For-publicly traded companies, please provide Form 10-K for 2023.

Attach 2022 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 2022. For-publicly traded companies, please provide Form 10-K for 2022.

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 30 Megabytes (MB).

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.

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.

Does this project meet the qualifications for the Green CHIPS program detailed below?

(1) is within the semiconductor manufacturing and related equipment and material supplier sector;
(2) includes sustainability measures to mitigate the project's greenhouse gas emissions over its lifetime under a Green CHIPS sustainability plan;
(3) provides for the payment of not less than federal prevailing wage rates for its project construction;
(4) makes specific and actionable commitments to worker and community investment under a Green CHIPS community plan;
(5) will create at least 500 (five hundred) net new jobs and make at least $3,000,000,000 (three billion dollars) in qualified investments prior to the conclusion of its preliminary schedule of benefits; and
(6) will maintain a Green CHIPS benefit-cost ratio of at least fifteen to one as calculated for the overall project term.

Please see question requirements for further information and a link to the regulations.

Applicant website

What is the applicant's Federal Tax ID#?

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

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

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

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

Electric Utility Company Name

Natural Gas Utility Company Name

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

A third party completing this application is required to disclose their name, company and contact name. Is a third party completing this application?

Provide the third party name and contact info.

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

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

Has the applicant applied for and/or been awarded funding from other New York State or local entities for this project?

Please detail the funding applied to for this project and the entity administering the funding. Do not include funding that has been awarded.

Please detail the funding awarded to this project and the entity administering the funding.

Has the applicant applied to and/or been awarded funding from a local IDA?

Please detail the funding applied for this project and the entity administering the funding. Do not include funding that has been awarded.

Please detail the funding awarded to this project and the entity administering the funding.

Does your company take advantage of or is considering taking advantage of employer provided childcare federal and state credits?

Does your company offer or is your company considering offering dependent care flexible spending accounts?

Do you wish to learn more about incentives for establishing or expanding childcare services on site or nearby?

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?

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

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)?

1. Agree to not pay less than the applicable federal prevailing wage and any required fringe benefits for construction performed as if the project were subject to 42 USC 3212.

2. 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.

3. 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.

4. 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.

5. Allow the Department of Economic Development and its agents access to any and all books and records the Department of Economic Development may require to monitor compliance.

6. 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.

7. 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.

8.Certify, under penalty of perjury, that the applicant is in substantial compliance with all environmental, worker protection, and local, state and federal tax laws.

9. Certify that I am 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.