A voluntary statement you can adapt and send to the embassy before your interview, or bring printed to your interview appointment. It demonstrates your planning for housing, employment, and health insurance — showing the officer that you and your sponsor have thought through financial self-sufficiency.
ℹ️ What this is and why it matters
The officer wants to see that you have thought through housing, employment, and health insurance. A clear, specific plan reads as low risk. No plan at all reads as a red flag. The embassy states this is voluntary. Community experience is that you should send it. It takes 20 minutes to write and removes one potential line of questioning at interview.
Be specific — a real address, a named employer, a named insurance provider. Specific details are more convincing than general plans.
Keep it concise — one to two paragraphs per section.
Include your case number in both the subject line and body so the unit can match it to your file.
Send it early — at least a few days before your interview. Last-minute submissions may not be reviewed in time.
Don't overthink it — if your situation is straightforward, say exactly that.
💡 How to submit
Email to LNDIVSubmissions@state.gov with your case number in the subject line, or upload directly to your case in CEAC. Do this at least a few days before your interview date.
Email Template
To: LNDIVSubmissions@state.gov
Subject: Public Charge Statement – [Your Case Number e.g. LND0123456789] – [Beneficiary Full Name]
Dear Immigrant Visa Unit,
I am writing to submit a voluntary public charge statement in advance of my immigrant visa interview. My case number is [LND0123456789] and my interview is scheduled for [DATE].
HOUSING
Upon entry to the United States, I will be living with my [spouse / family member], [Name], at [Full address, City, State, ZIP]. [If address not yet confirmed: We are currently in the process of securing accommodation in [City/State] and expect to confirm our address within [timeframe].]
EMPLOYMENT
I am a [job title / profession] with [X years] of experience in [sector/industry].
[Choose one:][Option A — continuing with current employer: I am currently employed by [Employer name] and plan to continue in my role with their US operations following my move. My employer has confirmed this arrangement.][Option B — seeking employment: I plan to seek employment in [sector] upon arrival. I have [relevant qualifications/experience] and expect to secure employment within [timeframe]. I have already begun [researching / applying for] roles in [City/State].]
During any period before employment begins, my [spouse / petitioner], [Name], will support our household financially. My petitioner's I-864 Affidavit of Support confirms this commitment.
HEALTH INSURANCE
[Choose one:][Option A — added to existing plan: I will be added to my [spouse's / family member's] employer-provided health insurance plan through [Employer name] once my Social Security Number is issued. The plan is provided by [Insurance provider] and covers [self and dependents / family].][Option B — purchasing own plan: I will obtain health insurance through [the Affordable Care Act marketplace / private provider]. I have researched available plans in [State] and expect the monthly premium to be approximately [$XXX].]
I am committed to supporting myself and my family independently and have no intention of relying on public benefits. I am happy to provide any additional information if required.
Yours sincerely,
[Beneficiary Full Name]
Case Number: [LND0123456789][Email address]
⚠️ Not legal advice
This template is based on community experience and is not legal advice. Your situation may differ. If you have complex circumstances — prior public benefits use, gaps in employment, medical conditions — consider consulting an immigration attorney before your interview.
Embassy scope note: This template is for the US Embassy London. The submission email address (LNDIVSubmissions@state.gov) is specific to London. If you are processing through a different embassy, confirm the correct submission address with your embassy.