Tool · Public charge

Public charge statement builder

Fill in what applies. The statement below updates as you type, in the order the officer needs it: income answers each cost, and savings come last as a buffer. Leave a box empty and its sentence is left out. When it reads right, copy it or download it, upload it to CEAC, then email it.

Before you start This produces the same statement as the template on the public charge page, without the brackets. Read what the officer weighs first if you have not. Have the sponsor's actual figures to hand: the beneficiary is the one questioned, and answers must match what you send. Your answers stay in this browser only.

1. You and your case

Case number

Your full name

Your email address

Interview date

Your age

English

Evidence of fluencyCompletes: "my ... has been conducted in English."

Highest qualification

Institution

Year awarded

Other licences, certifications or training (optional)

Your relationship to the petitioner

Relationship

Your dependents (leave empty if none)

The petitioner's dependents (everyone they support financially, not only tax dependents; leave empty if none besides you)

Any dependent's health or care need, and who pays (optional)

2. Health

Ongoing condition (leave empty if none)

Managed with

US cost

3. Housing

You will live with

Full US address (leave empty if not confirmed)

City and state

Expect to confirm within

Housing costs met by

4. Your work

Your job title or profession

Years of experience

Sector

Continuously employed in this field since

Current or most recent employer

With them since

If your profession is licensed in the US: status and timeline (optional)

After the move

My employer has confirmed in writing that I can work from the US

Current salary (US dollars per year)

If that arrangement ended, I would

Expect to find work within

Expected salary (US dollars per year)

Where

Without written confirmation from your employer, officers treat a remote job as uncertain. Either get the confirmation, or choose "I will look for work after arrival". Why.

5. The petitioner and sponsors

Petitioner's name

Petitioner's job title

Petitioner's employer

Annual income before tax

Annual income after taxQuestionnaires ask for after-tax salary. Give both.

Another working adult in the household (optional: name, job, employer, income)

Joint sponsor's name (leave empty if none)

Joint sponsor's job title

Joint sponsor's employer

Joint sponsor's annual income

Why you have a joint sponsor, in one true sentenceNot in the statement: this is for you to rehearse. What they ask about joint sponsors.

6. Health insurance

Cover after arrival

Through employer

Insurance provider

If that job ended, we would keep cover through

State

Expected monthly premiumA healthcare.gov quote for your age and ZIP code.

Premiums paid for by

7. Savings, assets and debts

Total savings (US dollars)

Held by

Would cover costs for about (months)

Of which in my name

Of which in the petitioner's name

Property or investments (optional; only what you can prove at the window)

Other income (optional)

Debts and liabilities, and how they are paid (leave empty if none significant)

I have a UK student loan

Plan

Balance (£)

Balance ($)

Expected monthly repayment ($)

Paid from

8. Public benefits and institutional care

Have you ever received means-tested benefits (for example Universal Credit, Housing Benefit, Council Tax Support), or used a food bank?

What, when, why, and what changed

The petitioner's history (leave empty if never)

The joint sponsor's history (leave empty if never)

Long-term institutional care at government expense, for you or the petitioner (leave empty if never; ordinary NHS care does not count)

9. Appendices: work and education history

Work history, one position per line, most recent firstTitle – employer – years. Posts ask for this as a list.

Education and qualifications, one per line, most recent first

10. Evidence you are attaching Petitioner IRS tax returns or transcripts, last 3 years Petitioner payslips, last 3 months Petitioner bank statements, last 3 months Petitioner health insurance, plan confirmation or summary of benefits Joint sponsor IRS tax returns or transcripts, last 3 years My UK student loan statement My employer's letter confirming I can work from the US

Your statement

Check every sentence is true and matches your documents. Then upload it to CEAC and email it to LNDIVSubmissions@state.gov at least five working days before the interview (when is that?).

Then rehearse it The officer asks the beneficiary, not the sponsor, and the answers need to match this statement. Answer these out loud, or drill the public charge flashcards.

← Back to public charge