The recipient entity's physical address:
           3347 Nicholson Drive A101
Baton Rouge, LA 70802

The recipient entity's mailing address (if different):
           PO Box 82068
Baton Rouge, LA 70820

Type of Entity (for instance, a nonprofit corporation):  Limited Liability Company

If the entity is a corporation, list the names of the incorporators:
          Carolyn Dragseth
James Moss
Valerie Clark
Kayla Cavalier
Zac Baum

The last four digits of the entity's taxpayer ID number:  0588

What is the dollar amount of the request?  $500,000

What type of request is this?  General Appropriation

Is this entity in good standing with the Secretary of State?  Yes

Provide the name of each member of the recipient entity's governing board and officers:
           Carolyn Dragseth- Chief Executive Officer
James Moss-Chief Operations Officer
Kayla Cavalier-Chief Financial Officer
Valerie Clark- Chief Compliance Officer
Zac Baum- Chief Science Officer

Provide a summary of the project or program:
           The Louisiana Nano Forge is a for profit LLC that originated in the identified need to create a consortium of entities to respond to the current CHiPS funding opportunities with an end state goal of creating a semiconductor manufacturing facility in the state of Louisiana. The company is working with universities, community colleges, small business, K-12 education and any other interested party to create a vibrant community that will create a positive impact on the economy of the state of Louisiana. The company seeks to coordinate and provide funding to scientists and their related schools to create a skilled semiconductor workforce as well as to create hands on training for anyone that is interested in entering the semiconductor workforce.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $14,050,594
          Professional Services. . . $0
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $10,100,200
          Major Repairs . . . . . . . $5,100,000
          Operating Services. . . . $4,514,400
          Other Charges. . . . . . . $16,052,360

Does your organization have any outstanding audit issues or findings?  No

If 'Yes' is your organization working with the appropriate governmental agencies to resolve those issues or findings?
          Not Applicable

What is the entity's public purpose, sought to be achieved through the use of state monies?
          We are looking for these funds to cover some of the salaries and initial operational costs for key personnel and equipment purchases. We have a list of current CHiPS proposals that have equipment needs and there are initial start up costs in order to provide the correct accounting for each of the proposals that are within the acquisition pipeline.

What are the goals and objectives for achieving such purpose?
          The goal is to create a vibrant semiconductor community with an end state goal of a semiconductor manufacturing facility within the state of Louisiana. The only way that this goal can be achieved is to continue to pursue funding opportunities as well to create an interest throughout the state in the semiconductor industry.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           5-15 years

If any elected or appointed state official or an immediate family member of such an official is an officer, director, trustee, or employee of the recipient entity who receives compensation or holds any ownership interest therein:
     (a) If an elected or appointed state official, the name and address of the official and the office held by such person:
                 N/A
    
     (b) If an immediate family member of an elected or appointed state official, the name and address of such person; the name, address, and office of the official to whom the person is related; and the nature of the relationship:
                 N/A

     (c) The percentage of the official's or immediate family member's ownership interest in the recipient entity, if any:
                 N/A

     (d) The position, if any, held by the official or immediate family member in the recipient entity:
                  N/A

If the recipient entity has a contract with any elected or appointed state official or an immediate family member of such an official or with the state or any political subdivision of the state:
(a) If the contract is with an elected or appointed state official, provide the name and address of the official and the office held by such person: 
               N/A

(b) If the contract is with an immediate family member of an elected or appointed state official:
          Provide the name and address of such person:
               N/A

          Provide the name, address, and office of the official to whom the person is related:
                N/A

          What is the nature of the relationship?  N/A

(c) If the contract is with the state or a political subdivision of the state, provide the name and address of the state entity or political subdivision of the state:
                 N/A

(d) The nature of the contract, including a description of the goods or services provided or to be provided pursuant to the contract:
               N/A


Contact Information
name:  Carolyn Dragseth 
                                       address:  PO Box 82068
Baton Rouge, LA 70820
                                       phone:  225-888-0015
                                       fax:  225-529-9899
                                       e-mail:  carolyn.dragseth@lananoforge.com
                                       relationship to entity:  CEO