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 Year1925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024 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
