Form

Application for a State Pension statement

You can apply for a State Pension statement using this form BR19. Fill it in with a pen or use the interactive version and post them to us.

Published 1 November 2012
Last updated 6 December 2018 — see all updates
From:
Department for Work and Pensions

Documents

Application for a State Pension statement you can fill in on screen – and then print

Ref: BR19 PDF, 1.55MB, 8 pages

Application for a State Pension statement you can print and fill in with a pen

Ref: BR19 PDF, 765KB, 8 pages

Welsh: Cais am ddatganiad Pensiwn y Wladwriaeth y gallwch ei lenwi ar y sgrin - ac yna argraffu

PDF, 1.36MB, 8 pages

This file may not be suitable for users of assistive technology. Request an accessible format.

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email accessible.formats@dwp.gsi.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Welsh: Cais am ddatganiad Pensiwn y Wladwriaeth y gallwch ei argraffu a'i llenwi â phen

Ref: BR19W PDF, 200KB, 8 pages

Details

You can use form BR19 to get a State Pension statement if:

  • you are aged 16 or over, and
  • at least 30 days away from your State Pension age when we look at your application

Form you fill in on screen using Adobe Reader (interactive)

To use this interactive PDF:

  • save it
  • fill it in
  • print the completed form
  • sign it
  • post it to the address on the form

You can fill in this form and save it using Adobe Reader XI or later. This means that you don’t have to complete the form in one go.

Form you fill in with a pen

To use this PDF:

  • print the form
  • fill it in with a pen
  • sign it
  • post it to the address on the form

Check online or by phone

You can also check your State Pension online or by phone.

Published 1 November 2012
Last updated 6 December 2018 + show all updates
  1. Added revised BR19 English and Welsh - print versions.
  2. Added revised BR19 forms (May 2018): Application for a State Pension statement - English and Welsh.
  3. Removed link to the State Pension online statement which is no longer available from 1 September 2015.
  4. First published.