Information Collection

CHIPS Full-Application Information Collection

IC 258879 under ICR 202303-0693-002 · OMB 0693-0094.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0693-0094 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument Placeholder.docx	Other-Placeholder
LEA Screenshots v2.pdf	Other-LEA Screenshots
20230303 - Cover Page Instruction Guide_vJP.docx	Other-Cover Page Instruction Guide
20230321 CHIPS full application Sources and Uses of Funds Instruction Guide vJP.docx	Other-sources and Use Instructions G
20230324 - CHIPS Incentives Request Instruction Guide vJP.docx	Other-Incentives Request Instruction
20230221 - Full App offline CHIPS Incentives Request - Formatted vJP.xlsx	Other-Full App Offline Incentives Re
20230303 - Full Application Offline Template - Sources Uses.xlsx	Other-Offline Template Sources and U
CHIPS Full App Supporting Statement 2023-02-25 v1 - FALD - Clean.docx Supporting Statement	IC Document
CHIPS Full App Supporting Statement 2023-02-25 v1 - FALD - Clean.docx Supporting Statement	IC Document
Emergency FRN Full App.pdf Published FRN	IC Document
Emergency FRN Full App.pdf Published FRN	IC Document
CHIPS Full Application Justification.pdf Emergency Justification	IC Document

IC Title:

CHIPS Full-Application Information Collection

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-LEA Screenshots	LEA Screenshots v2.pdf	Yes	Yes	Fillable Fileable
Other-Cover Page Instruction Guide	20230303 - Cover Page Instruction Guide_vJP.docx	Yes	Yes	Fillable Fileable
Other-sources and Use Instructions Guide	20230321 CHIPS full application Sources and Uses of Funds Instruction Guide vJP.docx	Yes	Yes	Fillable Fileable
Other-Incentives Request Instructions Guide	20230324 - CHIPS Incentives Request Instruction Guide vJP.docx	Yes	Yes	Fillable Fileable
Other-Full App Offline Incentives Request	20230221 - Full App offline CHIPS Incentives Request - Formatted vJP.xlsx	Yes	Yes	Fillable Printable
Other-Offline Template Sources and Uses	20230303 - Full Application Offline Template - Sources Uses.xlsx	Yes	Yes	Fillable Printable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 140

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	140	140
Annual IC Time Burden (Hours)	17,500	17,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement	CHIPS Full App Supporting Statement 2023-02-25 v1 - FALD - Clean.docx	03/03/2023
Published FRN	Emergency FRN Full App.pdf	03/03/2023
Emergency Justification	CHIPS Full Application Justification.pdf	03/24/2023

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