Marital Relationship Questionnaire

SSA uses Form SSA-4178 to collect information necessary to determine if two unrelated individuals who live together hold themselves out as a married couple to the community in which they live. If SSA determines that two individuals hold themselves out as married, SSA considers them married for the purposes of determining SSI eligibility and payment amount. SSA either mails or gives the individual Form SSA-4178 if the applicant or recipient allege a holding-out as married relationship; or if the SSI applicant or recipient denies holding out, but there is evidence to the contrary. The respondents are applicants for, and recipients of, SSI payments.

The latest form for Marital Relationship Questionnaire expires 2026-10-31 and can be found here.

Marital Relationship Questionnaire (Form SSA-4178)

Federal Enterprise Architecture: Income Security - General Retirement and Disability

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.