CHIPS Pre-Application Information Collection

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Overview

S&U - Project 1
S&U - Project 2
S&U - Summation across projects

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Sheet 1: S&U - Project 1

Template for Project Sources and Uses of Funds
Pre-Application Stage
	Project 1 Sources and Uses template
	Please refer to the Sources & Uses template instruction guide available for download in the pre-application section of the CHIPS Incentives Portal and at this link: https://www.nist.gov/document/chips-nofo-commercial-fabrication-facilities-pre-application-instructions.
	Applicants should complete this template on a best-efforts basis. Figures provided in this template are expected to be estimates and are permissible to be rough approximations for high-level cost categories.
	While estimated figures are allowable, applicants who provide greater detail in the Pre-Application phase will maximize the value of CPO pre-application feedback which can potentially accelerate the application and award processes.
	Please complete one template for each Project. Shared costs related to infrastructure improvements, workforce development, and other areas should be allocated across Projects.
	Project 1 - Facility Name
	Project 1 - Facility Description
	Schedule A: Project 1 - Uses Schedule				Schedule B: Project 1 - Funding Sources Schedule
	Uses of Funds	Amount (USD)	Percentage eligible for ITC		Sources of Funds	Amount (USD)
	1. Capital Investment	0.00			1. Equity Funding	0.00
	Land				Sponsor Equity (Applicant and/or Corporate Parent)
	Construction				Third-Party Equity
	Equipment				Other Equity Funding
	Infrastructure Improvements				[Insert description]
	Administrative Expenses directly attributable to facility construction				[Insert description]
	Other Capital Investment				[Insert description]
	[Insert description]				2. Debt Funding	0.00
	[Insert description]				Intercompany Debt from Corporate Parent
	[Insert description]				Third-Party Debt (e.g., Bonds or Loans)
	[Insert description]				Unguaranteed portion of Third-Party Loans Guaranteed by CHIPS Program
	[Insert description]				Other Debt Funding
	[Insert description]				[Insert description]
	[Insert description]				[Insert description]
	2. Operating losses and other cash outflows until project breaks even on a cash flow basis (Complete Schedule C below)	0.00			[Insert description]
	3. Workforce Development Costs	0.00			3. Government Support	0.00
	Equipment Costs				CHIPS Direct Funding
	Construction of Training Center				CHIPS Loans
	Training and Education Costs				Third-party Loans Guaranteed by CHIPS Program
	Wrap-Around Support Costs				Investment Tax Credit (estimated)
	Childcare Costs				State and Local Government Grants
	[Insert description]				State and Local Government Loans
	[Insert description]				State and Local Tax Credits
	[Insert description]				Other State and Local Government Incentives		<<provide instructions for how applicants should enter S&L if they do not know breakout between grants and loans
	[Insert description]				[Insert description]
	[Insert description]				[Insert description]
	4. Other Uses of Funds	0.00			[Insert description]
	[Insert description]				4. Other Sources of Funds (examples provided below)	0.00
	[Insert description]				Equipment Financing
	[Insert description]				Sale Leaseback or Other Real Estate Financing
	5. Total Project Costs	0.00			Customer Funding		<<add pre-payments to instruction guide as example
	Estimated Costs eligible for the Investment Tax Credit (ITC)				[Insert description]
					[Insert description]
					[Insert description]
					5. Total Project Funding	0.00
	Schedule C: Project 1 - Schedule for Operating Cash Flows until Project breaks even on a Cash Flow basis
		Amount (USD)
	1. Total sales until project breaks even on cash flow basis	0.00
	2. Total operating expenses until project breaks even on a cash flow basis	0.00
	[Insert description]
	[Insert description]
	[Insert description]
	[Insert description]
	[Insert description]
	Operating Income / Losses (excluding other operating income)	0.00
	3. Other operating income until project breaks even on a cash flow basis	0.00
	[Insert description]
	[Insert description]
	[Insert description]
	[Insert description]
	[Insert description]
	Operating Income / Losses	0.00
	4. Other cash flow items until project breaks even on a cash flow basis	0.00
	[Insert description]
	[Insert description]
	[Insert description]
	[Insert description]
	[Insert description]
	Earnings Before Interest and Taxes	0.00
	5. Total financing costs and taxes until project breaks even on a cash flow basis	0.00
	Interest Paid to Service Debt
	Payments to Third-Party Partners
	Other Financing Costs
	[Insert description]
	[Insert description]
	[Insert description]
	Corporate Taxes
	Other Taxes
	[Insert description]
	[Insert description]
	[Insert description]
	Operating losses and other cash outflows until project breaks even on a cash flow basis	0.00

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Sheet 2: S&U - Project 2

Template for Project Sources and Uses of Funds
Pre-Application Stage
	Project 2 Sources and Uses template
	Please refer to the Sources & Uses template instruction guide available for download in the pre-application section of the CHIPS Incentives Portal and at this link: https://www.nist.gov/document/chips-nofo-commercial-fabrication-facilities-pre-application-instructions.
	Applicants should complete this template on a best-efforts basis. Figures provided in this template are expected to be estimates and are permissible to be rough approximations for high-level cost categories.
	While estimated figures are allowable, applicants who provide greater detail in the Pre-Application phase will maximize the value of CPO pre-application feedback which can potentially accelerate the application and award processes.
	Please complete one template for each Project. Shared costs related to infrastructure improvements, workforce development, and other areas should be allocated across Projects.
	Project 2 - Facility Name
	Project 2 - Facility Description
	Schedule A: Project 2 - Uses Schedule				Schedule B: Project 2 - Funding Sources Schedule
	Uses of Funds	Amount (USD)	Percentage eligible for ITC		Sources of Funds	Amount (USD)
	1. Capital Investment	0.00			1. Equity Funding	0.00
	Land				Sponsor Equity (Applicant and/or Corporate Parent)
	Construction				Third-Party Equity
	Equipment				Other Equity Funding
	Infrastructure Improvements				[Insert description]
	Administrative Expenses directly attributable to facility construction				[Insert description]
	Other Capital Investment				[Insert description]
	[Insert description]				2. Debt Funding	0.00
	[Insert description]				Intercompany Debt from Corporate Parent
	[Insert description]				Third-Party Debt (e.g., Bonds or Loans)
	[Insert description]				Unguaranteed portion of Third-Party Loans Guaranteed by CHIPS Program
	[Insert description]				Other Debt Funding
	[Insert description]				[Insert description]
	[Insert description]				[Insert description]
	2. Operating losses and other cash outflows until project breaks even on a cash flow basis (Complete Schedule C below)	0.00			[Insert description]
	3. Workforce Development Costs	0.00			3. Government Support	0.00
	Equipment Costs				CHIPS Direct Funding
	Construction of Training Center				CHIPS Loans
	Training and Education Costs				Third-party Loans Guaranteed by CHIPS Program
	Wrap-Around Support Costs				Investment Tax Credit (estimated)
	Childcare Costs				State and Local Government Grants
	[Insert description]				State and Local Government Loans
	[Insert description]				State and Local Tax Credits
	[Insert description]				Other State and Local Government Incentives		<<provide instructions for how applicants should enter S&L if they do not know breakout between grants and loans
	[Insert description]				[Insert description]
	[Insert description]				[Insert description]
	4. Other Uses of Funds	0.00			[Insert description]
	[Insert description]				4. Other Sources of Funds (examples provided below)	0.00
	[Insert description]				Equipment Financing
	[Insert description]				Sale Leaseback or Other Real Estate Financing
	5. Total Project Costs	0.00			Customer Funding		<<add pre-payments to instruction guide as example
	Estimated Costs eligible for the Investment Tax Credit (ITC)				[Insert description]
					[Insert description]
					[Insert description]
					5. Total Project Funding	0.00
	Schedule C: Project 2 - Schedule for Operating Cash Flows until Project breaks even on a Cash Flow basis
		Amount (USD)
	1. Total sales until project breaks even on cash flow basis	0.00
	2. Total operating expenses until project breaks even on a cash flow basis	0.00
	[Insert description]
	[Insert description]
	[Insert description]
	[Insert description]
	[Insert description]
	Operating Income / Losses (excluding other operating income)	0.00
	3. Other operating income until project breaks even on a cash flow basis	0.00
	[Insert description]
	[Insert description]
	[Insert description]
	[Insert description]
	[Insert description]
	Operating Income / Losses	0.00
	4. Other cash flow items until project breaks even on a cash flow basis	0.00
	[Insert description]
	[Insert description]
	[Insert description]
	[Insert description]
	[Insert description]
	Earnings Before Interest and Taxes	0.00
	5. Total financing costs and taxes until project breaks even on a cash flow basis	0.00
	Interest Paid to Service Debt
	Payments to Third-Party Partners
	Other Financing Costs
	[Insert description]
	[Insert description]
	[Insert description]
	Corporate Taxes
	Other Taxes
	[Insert description]
	[Insert description]
	[Insert description]
	Operating losses and other cash outflows until project breaks even on a cash flow basis	0.00

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Sheet 3: S&U - Summation across projects

Template for Projects Sources and Uses of Funds
Pre-Application Stage
	Summation across Projects Sources and Uses template
	Please refer to the Sources & Uses template instruction guide available for download in the pre-application section of the CHIPS Incentives Portal and at this link: https://www.nist.gov/document/chips-nofo-commercial-fabrication-facilities-pre-application-instructions.
	Applicants should complete this template on a best-efforts basis. Figures provided in this template are expected to be estimates and are permissible to be rough approximations for high-level cost categories.
	While estimated figures are allowable, applicants who provide greater detail in the Pre-Application phase will maximize the value of CPO pre-application feedback which can potentially accelerate the application and award processes.
	Each cell in the Summation across Projects Sources and Uses template should be a basic summation across each of the corresponding cells in every project template completed.
	Schedule A: Summation across projects - Uses Schedule				Schedule B: Summation across projects - Funding Sources Schedule
	Uses of Funds	Amount (USD)	Percentage eligible for ITC		Sources of Funds	Amount (USD)
	1. Capital Investment	0.00			1. Equity Funding	0.00
	Land				Sponsor Equity (Applicant, Intermediate entity, and/or Corporate Parent)
	Construction				Third-Party Equity
	Equipment				Other Equity Funding
	Infrastructure Improvements				[Insert description]
	Administrative Expenses directly attributable to facility construction				[Insert description]
	Other Capital Investment				[Insert description]
	[Insert description]				2. Debt Funding	0.00
	[Insert description]				Intercompany Debt from Corporate Parent
	[Insert description]				Third-Party Debt (e.g., Bonds or Loans)
	[Insert description]				Unguaranteed portion of Third-Party Loans Guaranteed by CHIPS Program
	[Insert description]				Other Debt Funding
	[Insert description]				[Insert description]
	[Insert description]				[Insert description]
	2. Operating losses and other cash outflows until project breaks even on a cash flow basis (Complete Schedule C below)	0.00			[Insert description]
	3. Workforce Development Costs	0.00			3. Government Support	0.00
	Equipment Costs				CHIPS Direct Funding
	Construction of Training Center				CHIPS Loans
	Training and Education Costs				Third-party Loans Guaranteed by CHIPS Program
	Wrap-Around Support Costs				Investment Tax Credit (estimated)
	Childcare Costs				State and Local Government Grants
	[Insert description]				State and Local Government Loans
	[Insert description]				State and Local Tax Credits
	[Insert description]				Other State and Local Government Incentives		<<provide instructions for how applicants should enter S&L if they do not know breakout between grants and loans
	[Insert description]				[Insert description]
	[Insert description]				[Insert description]
	4. Other Uses of Funds	0.00			[Insert description]
	[Insert description]				4. Other Sources of Funds (examples provided below)	0.00
	[Insert description]				Equipment Financing
	[Insert description]				Sale Leaseback or Other Real Estate Financing
	5. Total Projects Costs	0.00			Customer Funding		<<add pre-payments to instruction guide as example
	Estimated Costs eligible for the Investment Tax Credit (ITC)				[Insert description]
					[Insert description]
					[Insert description]
					5. Total Projects Funding	0.00
	Schedule C: Summation across projects - Schedule for Operating Cash Flows until Projects breaks even on a Cash Flow basis
		Amount (USD)
	1. Total sales until projects break even on cash flow basis	0.00
	2. Total operating expenses until projects break even on a cash flow basis	0.00
	[Insert description]
	[Insert description]
	[Insert description]
	[Insert description]
	[Insert description]
	Operating Income / Losses (excluding other operating income)	0.00
	3. Other operating income until projects break even on a cash flow basis	0.00
	[Insert description]
	[Insert description]
	[Insert description]
	[Insert description]
	[Insert description]
	Operating Income / Losses	0.00
	4. Other cash flow items until projects break even on a cash flow basis	0.00
	[Insert description]
	[Insert description]
	[Insert description]
	[Insert description]
	[Insert description]
	Earnings Before Interest and Taxes	0.00
	5. Total financing costs and taxes until projects break even on a cash flow basis	0.00
	Interest Paid to Service Debt
	Payments to Third-Party Partners
	Other Financing Costs
	[Insert description]
	[Insert description]
	[Insert description]
	Corporate Taxes
	Other Taxes
	[Insert description]
	[Insert description]
	[Insert description]
	Operating losses and other cash outflows until projects break even on a cash flow basis	0.00
	Question 1: Provide an explanation on how the equity injected into the project legal entity (by the applicant, its corporate parent or third-party partners) is funded. If debt is raised on the corporate parent’s or third-party partner's balance sheet, outside of the project legal entity structure, and then downstreamed as equity, please provide details on the amount of debt attributable to this project.
	Question 2: If known, provide information on the key features and terms & conditions related to the debt funding raised by the applicant (e.g., Tenor, Fixed vs. Floating rate, Interest rate, Amortization features, pre-payment optionality).
	Question 3: Explain how you estimated the value of the benefit from the Investment Tax Credit.
	Question 4: Are there any other state or local incentives that provide funding in a form that is not a direct grant or loan, such as reduced utilities costs, reduced taxes, etc.? If yes, please describe and estimate incentive amount(s) through the life of the project, and through the time period until cash flows turn positive.
	Question 5: Is there any other information related to Sources of Funds for the project or facilities that we should know?
	Question 6: Is there any other information related to Uses of Funds for the project or facilities that we should know?