Your%National%Insurance%number
About%this%form When%to%complete%this%form
012*3451*6789*37: !79LD232*3451*6789*56*B7=:
;* 82<=213*>85332?*@7?6589A357?*76*B7=8*CA357?AD*E?1=8A?@2* ;* 4AQ2*A*CECH*A?J*?22J*=1*37*@7?6589*53*5?*>8535?K*F2@A=12*B7=*
?=9F28*GCECHI*A?J,78 4AQ2*F22?*=?AFD2*37*82<=213*53*FB*L47?2
;* 32DD*=1*AF7=3*A*@4A?K2*37*B7=8*L2817?AD*J23A5D1M ;* 4AQ2*82@2?3DB*82@25Q2J*?73565@A357?*76*B7=8*CECH*A?J*?22J*37*
=LJA32*B7=8*L2817?AD*J23A5D1
Where%to%find%your%NINO
;* 4AQ2*F22?*37DJ*37*FB*A?*AJQ5178*7?*7?2*76*342*CA357?AD*
E6*B7=*J7*?73*N?7>*B7=8*CECH*B7=*95K43*F2*AFD2*37*65?J*53*7?*
E?1=8A?@2*'2DLD5?21M
7665@5AD*LAL28>78N*1=@4*A1:*
;* B7=8*6789*-O%*End$of$Year$CertificateP*K5Q2?*37*B7=*FB*
When%not%to%complete%this%form
B7=8*29LD7B28
X7*?73*@79LD232*3451*6789*56*B7=:
;* A*LAB1D5L
;**4AQ2*?2Q28*4AJ*A*CECH*F26782*A?J*A82*=?J28*AK2*Y%M*
;* A*@7LB*76*B7=8*A??=AD*R2D6*"1121192?3*3AS*823=8?
-47?2*342*CA357?AD*E?1=8A?@2*)2K5138A357?1*'2DLD5?2*7?%
;* 73428*7665@5AD*@78821L7?J2?@2*6879*'(*)2Q2?=2*T*!=13791*
0845%915%7006*678*AJQ5@2
;**4AQ2*?2Q28*4AJ*A*CECH*F26782*A?J*A82*7Q28*AK2*Y%M*-47?2*
G'()!IM
Z7F@2?382*-D=1*7?*0845%600%0643%678*AJQ5@2*78*K7*37*
Written%confirmation%of%your%NINO
www.direct.gov.uk%
E6*B7=*?22J*>85332?*@7?6589A357?*76*B7=8*CECH*B7=*J7?U3*4AQ2*37*
;* >A?3*A*D23328*5?*[2D14*@7?65895?K*B7=8*CECHP*LD2A12*L47?2*
65DD*5?*3451*6789*37*K23*3451*5?6789A357?*6879*=1M*V7=*@A?P*56*B7=*
0845%302%1489*A?J*A1N*678*6789*!"#$%&[M
>A?3P*L47?2*7=8*CA357?AD*E?1=8A?@2*)2K5138A357?1*'2DLD5?2*7?*
0845%915%7006*A?J*342B*>5DD*A88A?K2*37*12?J*@7?6589A357?*37*
What%to%do%next
E6P*A6328*@7?15J285?K*ADD*76*342*5?6789A357?*AF7Q2P*B7=*135DD**
B7=M*E6*B7=*D5Q2*7=315J2*342*0WP*L47?2*
>A?3*37:
+44%191%203%7010M
;* 82<=213*>85332?*@7?6589A357?*76*B7=8*CECH*A?J,78
Please%note%a%letter%confirming%your%NINO%cannot,%on%its%
;* 32DD*=1*AF7=3*A*@4A?K2*5?*B7=8*L2817?AD*J23A5D1
own,%be%used%to%prove%your%identity.%
@79LD232*3451*6789M*(AN2*1=82*B7=*82AJ*A?J*15K?*342*
X2@DA8A357?*7?*LAK2*YM*
-D2A12*=12*@AL53AD*D233281*A?J*>8532*@D2A8DB*5?*FDA@N*5?NM*
*\*E?J5@A321*82<=582J*652DJM
-D2A12*3=8?*7Q28*]]]
!"#$%& -"./*+* '()!*+%,+&
-"./*Y*
Your%details
^53D2*_*$for$example$Mrs,$Miss,$Ms,$Mr,$Dr,$Rev$*
R=8?A92*\
`5813*?A921**\
-82Q57=1*1=8?A92*if$applicable
-82Q57=1*65813*?A921*if$applicable
.2?J28*Please$tick$the$appropriate$box$$*
(AD2 `29AD2
XA32*76*F5834*DD$MM$YYYY$$$*
!=882?3*4792*AJJ8211**\
-713@7J2
!7?3A@3,(7F5D2*L47?2*?=9F28
CA357?AD*E?1=8A?@2*?=9F28$if$known
"82*B7=*@79LD235?K*3451*6789*37*32DD*=1*AF7=3*A*@4A?K2*37*
B7=8*?A92a**\
C7
V21
**-D2A12*K5Q2*J23A5D1*F2D7>*
-D2A12*32DD*=1*>4B*B7=*4AQ2*@4A?K2J*B7=8*?A92*
married,$civil$partnership,$deed$poll$or$other$reason$
XA32*76*?A92*@4A?K2**DD$MM$YYYY$*
Your%address%details%%-D2A12*32DD*=1*B7=8*DA13*3>7*L82Q57=1*AJJ821121*if$applicable
"JJ8211*+
-713@7J2
-D2A12*32DD*=1*>42?*B7=*D5Q2J*A3*3451*AJJ8211
`879
^7
"JJ8211*Y*
-713@7J2
-D2A12*32DD*=1*>42?*B7=*D5Q2J*A3*3451*AJJ8211
`879
^7
-"./*3*
Marriage%or%civil%partnership%details
"82*B7=*9A8852J*78*5?*A*@5Q5D*LA83?28145La**\
C7
V21
**-D2A12*K5Q2*J23A5D1*F2D7>*
(A8852J
!5Q5D*
LA83?28145L
XA32*76*9A885AK2*78*@5Q5D*LA83?28145L*DD$MM$YYYY$
'AQ2*B7=*2Q28*F22?*9A8852J*78*5?*A*@5Q5D*LA83?28145L*5?*
342*LA13a**
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C7
V21
**-D2A12*K5Q2*J23A5D1*F2D7>*
XA32*76*9A885AK2*78*@5Q5D*LA83?28145L*DD$MM$YYYY$
XA32*76*J5Q78@2*78*J5117D=357?*76*@5Q5D*LA83?28145L*
DD$MM$YYYY$
)2A17?*>4B*9A885AK2*78*@5Q5D*LA83?28145L*2?J2J*
divorce,$dissolved,$widowed$or$other$reason$
Declaration
-D2A12*15K?*A?J*JA32*342*J2@DA8A357?*F2D7>M*
E*J2@DA82*34A3*342*5?6789A357?*E*4AQ2*K5Q2?*7?*3451*6789*51*
@7882@3*A?J*@79LD232M*
R5K?A3=82
XA32
What%you%need%to%do%now
!42@N*34A3*B7=*4AQ2:
;* @79LD232J*ADD*76*342*<=21357?1*34A3*ALLDB*37*B7=
;* 15K?2J*342*J2@DA8A357?
;* 3AN2?*A*@7LB*76*B7=8*@79LD232J*6789*678*B7=8*82@78J1M
R2?J*342*785K5?AD*@79LD232J*6789*37:*
'(*)2Q2?=2*T*!=13791*
CA357?AD*E?1=8A?@2*!7?385F=357?1*T*/9LD7B28*H665@2*
CA357?AD*E?1=8A?@2*)2K5138A357?1*
b2?37?*-A8N*c52>*
C2>@A13D2*=L7?*^B?2**
C/de*+ff
`78*7665@5AD*=12*7?DB:*CA357?AD*E?1=8A?@2*?=9F28*38A@2J
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HMRC CA5403 National Insurance Number

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Completed 8 March 2020

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