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.
US Code:
42
USC 1383 Name of Law: Social Security Act
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.