Public Charge Questionnaire

OMB 1405-0234

OMB 1405-0234

The Department seeks to better ensure that aliens subject to the public charge inadmissibility ground are self sufficient and will not rely on public resources to meet their needs, but rather, will rely on their own capabilities, as well as the resources of sponsors. Through the DS–5540, the Department will collect information in a standardized format regarding applicants’ ability to financially support themselves following entry into the United States, without depending on government assistance. Fields primarily pertain to the applicant’s health, family status, assets, resources, financial status, education, skills, health insurance coverage, and tax history. The DS–5540 would also require applicants to provide information on whether they have received certain specified public benefits from a U.S. Federal, state, local or tribal government entity.

The latest form for Public Charge Questionnaire expires 2020-08-31 and can be found here.

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