Statement of Marital Relationship

OMB 0960-0038

OMB 0960-0038

Where no formal marriage documentation exists, SSA uses information we collect on Form SSA-754-F4 to determine whether an individual applying for spousal benefits meets the criteria of common-law marriage under state law. The respondents are applicants for a spouse's Federal Old-Age, Survivors, and Disability insurance benefits.

The latest form for Statement of Marital Relationship expires 2021-02-28 and can be found here.

Latest Forms, Documents, and Supporting Material
All Historical Document Collections
Revision of a currently approved collection 2021-01-28
Approved without change
Revision of a currently approved collection 2017-10-20
Approved without change
No material or nonsubstantive change to a currently approved collection 2015-10-26
Approved without change
Extension without change of a currently approved collection 2014-11-05
Approved without change
Revision of a currently approved collection 2012-02-02
Approved without change
Revision of a currently approved collection 2009-03-05
Approved without change
Extension without change of a currently approved collection 2006-01-17
Approved without change
Extension without change of a currently approved collection 2002-12-19
Approved without change
Extension without change of a currently approved collection 1999-10-12
Approved without change
Extension without change of a currently approved collection 1996-09-20
Approved without change
Extension without change of a currently approved collection 1993-08-25
Approved without change
Extension without change of a currently approved collection 1990-08-08
Approved with change
No material or nonsubstantive change to a currently approved collection 1989-04-24
Approved without change
Extension without change of a currently approved collection 1987-10-02
Approved without change
Extension without change of a currently approved collection 1984-12-05
Approved without change
Extension without change of a currently approved collection 1982-03-04
Approved without change
Revision of a currently approved collection 1978-06-26
Approved without change
Extension without change of a currently approved collection 1974-12-16

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