Ah, yes, unfortunately you were missing almost ALL the documents you needed, for every section of the application form.
So, even if you had sent all the financial documents, you would have been refused on the accommodation requirement, the relationship requirement (even though it says you meet it) AND your NHS debt.
I’m aware that the guidelines have changed and that we now must send photos and messages to prove our relationship, we sent neither of those items.
The guidelines changed several years ago, so it's really not a new or recent thing at all.
Here's my general list of things you need to send (obviously it should be tailored to your exact circumstances though):
Applicant (US citizen)- Receipt for priority processing (if paying for priority)
- return shipping label
- Optional cover letter (contents only, and explaining the reasons for your previous refusal)
- Printed online application form (don't submit until you have all the documents in your hands and are completely ready to mail the application package to Sheffield)
- Completed VAF4a Appendix 2 form
- Stamped Biometrics Confirmation Sheet (when you have attended the biometrics appointment)
- Receipt for IHS surcharge payment
- 1 passport photo (they can be US or UK size)
- US passport
- All previous passports
- Refusal letter
- Receipt for payment of NHS debt, or a letter from the NHS explaining why you were not charged and that you don't have to pay
Sponsor (UK citizen)- Copy UK passport photo page (photocopy usually okay, but can be certified by the Post Office)
- Sponsor letter of support for the visa
AccommodationIf he rents:
- original tenancy agreeement
- a letter from the landlord giving you permission to live there
FinancesCategory F Director of Limited CompanyALL of the documents listed in the refusal letter... this will be for the 2017/2018 tax year now
OR
Category D: Cash Savings:- 6 full months of original bank statements showing at least £62,500 in the account on every single day of the 6 months
- statements/letters from anyone who has gifted you money stating it is a gift, not a loan, and will not be repaid
Relationship evidence- marriage certificate
- 1 or 2 photos of you together (i.e. one at the wedding and one earlier in the relationship)
- boarding passes from trips to see each other
- any physical letters and cards sent to each other
- 1-2 pages of screenshots of your Skype call logs
- 1-2 pages of screenshots of FB messages
PhotocopiesYou should also include photocopies of all original documents you wish to be returned to you.