You must file Form DS-5540, Public Charge Questionnaire with your US immigration visa application, in order to prove that you will not rely on public benefits, such as food stamps, after you enter the United States. Form DS-5540 is required only for those who apply for lawful permanent resident status from outside the US — those who apply for adjustment of status to permanent resident within the United State must file Form I-944 instead.

Form DS-5540 requires you to make many declarations about your personal life and your finances. Making declarations is not enough, however — you must prove your declarations with documentary evidence, and it is usually best to provide too much rather than too little. Following are some of the documents you are likely to need to file with Form DS-5540.

Document Checklist

  • Your marriage certificate, if you changed your name due to marriage and your name is listed differently on different documents.
  • Proof of current or future health insurance and coverage in the United States (a copy of the policy itself, with your signature and the signature of a company representative, would be best). The policy should list the dates of coverage.
  • Proof of your income: Official pay stubs for the past six months can be used to prove your salary, as can a bank statement issued by your bank that shows deposits into your account. Other income such as stock dividends, rental income, pension income, child support, investment income, royalties, etc. can be established with appropriate documentation issued by the source — an official pension statement issued by the payer, a child support order issued by a court, a royalty agreement, etc.
  • Proof of your assets and their value. If you own a house, for example, you could submit a copy of the deed, along with a professional appraisal of its value. You should also include documents proving any stock ownership, etc. The contents of your bank account can be established with a 12-month bank statement issued by the bank.
  • Your U.S. federal tax returns for the past three years. You can receive an official tax transcript from the IRS upon request.You will also need to include supplementary forms such as W-2, 1099s, etc.
  • A verification of employment letter from your current employer, issued on company letterhead and signed by your employer. If you are currently employed. If you are entering the US with a job offer, you can submit your offer letter. If your immigrant visa application is based on employment, you will need to submit this information with other parts of your application anyway — you needn’t prepare two copies.
  • Proof of education. You will need a diploma and preferably a transcript as well, for each degree you earned. A transcript showing your grades will be particularly useful if you were a good student.
  • Copies of any job certifications and licenses that you possess — an electrician’s license, for example.
  • Evidence of your receipt of public benefits. You should receive a notification letter when your application for the benefit is approved, and you can submit this as evidence.
  • Military service records issued by the US military, if any member of your household was in active duty military service while receiving US public benefits. These records can help your application.
  • Documents proving any other declaration you make, if the nature of the declaration is such that it can be proven with documentary evidence.

You may be requested to provide other documents as well.

Important Notes

Missing documents: If a required document is unavailable in your country, you will need to submit a detailed written explanation why you cannot obtain it when you submit Form DS-5540.Failure to submit a required document could delay your case or even result in rejection of your application.

Certification: If the document you need is issued by a government (such as a marriage certificate, for example), the government will insist on keeping the original document in its own files. Try to obtain a certified copy from the government instead. Submitting a handmade photocopy may or may not be accepted, and this should be avoided if possible due to the ease with which a photocopy can be forged.

Translations: Any document not written in English must be accompanied by a certified translation in which the translator certifies that the translation is accurate and complete to the best of the translator’s knowledge. The translator should be a professional translator working for a recognized translation agency. Failure to submit an appropriate translation could result in your application being treated as if you had not included the document at all.

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