The Disability Rights Education and Defense Fund (DREDF), a national law and policy center dedicated to advancing the rights of people with disabilities, is currently working to address the marriage penalties that people with disabilities who are receiving social security benefits face. As part of this effort, we are collecting stories from people who have been affected by these penalties. Nothing about anyone's story will be shared without their permission. We hope to hear from you.

You can learn more about marriage equality for people with disabilities at https://dredf.org/marriage-equality/. 

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* 1. What is your first and last name?

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* 2. What is your email?

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* 3. What is your telephone number?

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* 4. What benefit do you and/or your partner receive? (e.g. SSI, DAC, etc)

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* 5. What disability/disabilities do you have?

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* 6. Are you on Medicaid or Medicare?

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* 7. How old are you?

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* 8. Are you in a relationship?

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* 9. If you are in a relationship, what is the current status of your relationship?

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* 10. What is your understanding of the marriage penalties for people on your or your partner's benefit?

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* 11. Have you personally been impacted by the marriage penalties for people on your or your partner's benefit? If yes, how?

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* 12. Are you religious? If so, what are your religious beliefs?

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* 13. What is your zip code?

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* 14. Are you willing to have your story shared?

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