Information Collection

CHIPS Statement of Interest Information Collection

IC 258420 under ICR 202302-0693-002 · OMB 0693-0091.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0693-0091 can be found here:

Documents and Forms

Document Name Document Type
(2023.02.08) SOI Review Document with JKS edits_DOC Response.docx Other-SOI
CHIPS SOI Screenshots.pdf Other-Application
Incentives_SOI_Screenshots drop down.pdf Other-Application
2023-02-24 SOI Instructions Guide_vF Clean v2.docx Other-Instructions
SOI Emergency Justification Letter Draft.docx Draft Emergency Justification IC Document
FRN SOI.pdf FRN IC Document
FRN SOI.pdf FRN IC Document
CHIPS SOI Supporting Statement.docx Supporting Statement IC Document
(2023.02.08) SOI Instructions Guide.docx Instructions Guide IC Document
(2023.02.08) CHIPS Statement of Interest Certifications with jks comments_DOC Response.docx SOI Certifications IC Document
2023-02-24 CHIPS SOI Supporting Statement A CLEAN.docx Supporting Statement Part A IC Document
2023-02-24 Supporting Statement B.docx Supporting Statement Part B IC Document
2023-02-24 SOI Instructions Guide_vF Clean v2.docx Instructions Guide IC Document
CHIPS Statement of Interest Certifications 2_24_23.docx Certifications IC Document
SOI Justification Letter.pdf Emergency Justification Letter IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	CHIPS Statement of Interest Information Collection	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Application	CHIPS SOI Screenshots.pdf	Yes	Yes	Fillable Fileable
Other-Application	Incentives_SOI_Screenshots drop down.pdf	Yes	Yes	Fillable Fileable
Other-Instructions	2023-02-24 SOI Instructions Guide_vF Clean v2.docx	Yes	No	Printable Only

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 350	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	350	350
Annual IC Time Burden (Hours)	175	175
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
FRN	FRN SOI.pdf	02/08/2023
Supporting Statement Part A	2023-02-24 CHIPS SOI Supporting Statement A CLEAN.docx	02/24/2023
Supporting Statement Part B	2023-02-24 Supporting Statement B.docx	02/24/2023
Instructions Guide	2023-02-24 SOI Instructions Guide_vF Clean v2.docx	02/24/2023
Certifications	CHIPS Statement of Interest Certifications 2_24_23.docx	02/24/2023
Emergency Justification Letter	SOI Justification Letter.pdf	02/24/2023

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.