You must have JavaScript enabled to use this form. Your details Full name National Insurance number It’s on your National Insurance card, benefit letter, payslip or P60. For example, ‘QQ 12 34 56 C’. Date of birth Date of birth: Day Day12345678910111213141516171819202122232425262728293031 Date of birth: Month MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Date of birth: Year Year1924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023 For example, 31 March 1980 Your address Member address Address Line 1 Address Line 2 (Optional) Town or city County (optional) Postcode Contact details Email address We’ll use this to send you a confirmation Telephone number Your previous address Previous address Address Line 1 Address Line 2 (Optional) Town or city County (optional) Postcode
