# @TITLE@

## Metadata
| Key | Value |
| --- | --- |
| ID | @ID@ |
| CrossReference | @CROSSREF@ |

## Version History
| Date | Status | Author | Reviewer | Change | Commit |
| --- | --- | --- | --- | --- | --- |
| @DATE@ | Proposed | @AUTHOR@ | <reviewer S-ID> | Initial version | pending |

---

## Artifact Under Review

- Instance reviewed: [<INSTANCE-ID>]
- Checklist used: [<QC-ID>] (`QC-<short-name>-<version>`, e.g. `QC-BC-001`)
- Scope: <full review | delta re-review of criteria <numbers>, reason, earlier record [<RC-ID>]>
- Language and domain: <Language> / <Domain> (the artifact's Metadata rows), or `n/a` for a technical type
- Language reviewer: <stakeholder ID>, or `none` when the reviewer reads the language and knows the domain

## Checklist Results

| # | Criterion | Status | Evidence/Notes |
| --- | --- | --- | --- |
| 1 | <criterion copied from the QC checklist> | Pass/Fail/N-A | |

## Language and Domain Results

Only for an artifact of a type written in the PO language: the rows of
`QC-LANG-001`, in order. Delete this section for a technical type.

| # | Criterion | Status | Evidence/Notes |
| --- | --- | --- | --- |
| 1 | <criterion copied from QC-LANG-001> | Pass/Fail/N-A | |

## Overall Verdict

<Go / Go-with-conditions / No-Go> — <rationale>

## Action Items

| Action | Owner | Due |
| --- | --- | --- |
| <action> | <stakeholder ID, e.g. S07> | <date> |

---

@LINKS@