State Specifications Worksheet

Purpose of this document

The State Specifications Worksheet is required for all state agency requesters. It collects detailed requester information, study/project data extract details, shipping information, and method of payment. It also includes a Part D event justification tab that is required for all requests that include Part D data. The State Specifications Worksheet is used by the data distributor to generate a cost invoice and to collect data extraction information.

Note: There are other versions of the specifications worksheet for qualified entities and all other RIF requests.

Who uses this document

All state agencies submitting RIF requests must include a complete a State Specifications Worksheet.

Document Version:
09/2023
Format:
Microsoft Excel