UK CA5403 Form – Fill Out and Use This PDF

About this form

Use this form to:

•request written confirmation of your National Insurance number (NINO) and/or

•tell us about a change to your personal details.

Where to find your NINO

If you do not know your NINO you might be able to find it on official paperwork such as:

•your form P60 End of Year Certificate, given to you by your employer

•a payslip

•a copy of your annual Self Assessment tax return

•other official correspondence from HM Revenue & Customs (HMRC).

Written confirmation of your NINO

If you need written confirmation of your NINO you don't have to fill in this form to get this information from us. You can, if you want, phone our National Insurance Registrations Helpline on 0845 915 7006 and they will arrange to send confirmation to you. If you live outside the UK, phone

+44 191 203 7010.

Please note a letter confirming your NINO cannot, on its own, be used to prove your identity.

*Indicates required field.

When to complete this form

Complete this form if you:

•have a NINO and need us to confirm it in writing because you have been unable to request it by phone

•have recently received notification of your NINO and need to update your personal details

•have been told to by an advisor on one of the National Insurance Helplines.

When not to complete this form

Do not complete this form if you:

•have never had a NINO before and are under age 20. Phone the National Insurance Registrations Helpline on 0845 915 7006 for advice

•have never had a NINO before and are over age 20. Phone Jobcentre Plus on 0845 600 0643 for advice or go to www.direct.gov.uk

•want a letter in Welsh confirming your NINO, please phone 0845 302 1489 and ask for form CA5403W.

What to do next

If, after considering all of the information above, you still want to:

•request written confirmation of your NINO and/or

•tell us about a change in your personal details complete this form. Make sure you read and sign the Declaration on page 2.

Please use capital letters and write clearly in black ink.

Please turn over >>>

Your details

Title – for example Mrs, Miss, Ms, Mr, Dr, Rev *

Surname *

First names *

Previous surname if applicable

Previous first names if applicable

Gender Please tick the appropriate box *

Male

Female

Date of birth DD MM YYYY *

Current home address *

Postcode

Contact/Mobile phone number

National Insurance number if known

Are you completing this form to tell us about a change to your name? *

No

Yes Please give details below

Please tell us why you have changed your name married, civil partnership, deed poll or other reason

Date of name change DD MM YYYY

Postcode

Please tell us when you lived at this address

Postcode

Please tell us when you lived at this address

From

From

To

To

Declaration

Please sign and date the declaration below.

I declare that the information I have given on this form is correct and complete.

Signature

Date

What you need to do now

Check that you have:

•completed all of the questions that apply to you

•signed the declaration

•taken a copy of your completed form for your records.

Send the original completed form to:

HM Revenue & Customs

National Insurance Contributions & Employer Office National Insurance Registrations

Benton Park View Newcastle upon Tyne NE98 1ZZ