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+## Jira Ticket
+<!-- Please include the relevant Jira ticket link below -->
+- [FFS-XXXX](https://jiraent.cms.gov/browse/FFS-XXXX)
+
+## Description
+<!-- Provide a summary of the changes and the motivation for this PR -->
+
+## Submitter Checklist
+<!-- Please check the boxes below as you complete each task -->
+- [ ] **Jira Ticket:** The relevant Jira ticket is linked in the header.
+- [ ] **Evidence of Testing:** I have included evidence of bench testing (e.g., terminal output, screenshots, logs) below.
+- [ ] **Security Boundary:** I have checked if any security boundaries are changing.
+  - [ ] If yes, [I have pointed to the relevant Security Impact Analysis (SIA)](https://confluenceent.cms.gov/spaces/SFIV/pages/693666588/Architectural+Decision+Records+ADRs) or escalated to the security team.
+- [ ] **Backwards Compatibility:** I have verified that these changes do not introduce any backwards compatibility issues.
+  - [] If no, I have added appropriate new versions or feature flags and [flagged the team and appropriate stakeholders](https://confluenceent.cms.gov/spaces/SFIV/pages/1325579907/DRAFT+API+Change+Standards)
+- [ ] I've updated the Confluence documentation, content in the /docs folder, and any API spec docs
+## Reviewer Checklist
+<!-- To be completed by the reviewer -->
+- [ ] **Verification:** I have verified that the changes work as intended.
+- [ ] **Backwards Compatibility:** I have confirmed that the code does not introduce any backwards compatibility issues.
+- [ ] **Security & Privacy:** I have reviewed the changes for potential security or privacy risks (e.g., PII handling).
+- [ ] **Contract Compliance:** If the public API contract changed, I have verified that it is reflected in `api-spec/` and follows the organization's standards.
+- [ ] **Code Quality:** The code is clean, well-tested, and follows the established patterns in the codebase.
+- [ ] **Code Quality:** The code has unit and integration tests that cover relevant code changes.
+
+## Evidence of Testing
+<!-- Provide evidence of your bench testing here (e.g., `go test` output, CURL results, etc.) -->
+
+```text
+Paste test results here
+```