<Name>

<Address>
<email@gmail.com>
<mobile number>
<Date>

To,
The Under Secretary (IC),
International Cooperation Section,
Ministry of Health & Family Welfare (Department of Health &Family Welfare),
Room No.504, 'D' Wing, Nirman Bhawan,
New Delhi - 110011.

Subject: Application for Statement of Need (SoN)

Dear Sir/Madam,

I am <Name> (USMLE/ECFMG ID No. _________), currently a __________________________. I am

an MBBS graduate of _______________________. I have been selected for an ______________
Residency Program starting on ___________ for <1/3/4> years of duration at
_____________________________, USA. In that regard, I wish to apply for a statement of need
certificate in the format approved by the ECFMG, USA, to be sponsored by them for a J1 (alien
physician) visa. I have attached the following documents as per the published guidelines:

1. Application form (Annex-A)

2. Copy of offer letter/resident agreement from the institution (___________________)
(self-attested)
3. Copy of current valid passport excluding blank pages (self-attested)
4. Copy of _________ visa, <DS-2019/I20 if any>, latest I94, in relation to my stay in the US
(self-attested)
5. Original surety bond (Annex-1) of Rs 10 lacs on Rs <100/300> non-judicial stamp paper
along sureties’ biodata (Annex-C & D) and ITR declaration

I do undertake to return to India upon completion of my training in the United States and enter the
practice of medicine in the specialty of training. As per the ECFMG website, a scan of the statement
of need in the prescribed format may be emailed to the ECFMG at their email MoH@ECFMG.org
from the official Ministry of Health and Family Welfare email address.

Kindly do the needful and oblige.

Thanking you,

<Name>