Social Security Nr. Application Form Fill out application form online 1Health Insurance Details2Personal Details Hiddendate HiddenlanguageendefresAre you insured with a statutory health insurance in Germany?*Statutory health insurance: AOK, TK, etc. NO statutory health insurance: Mawista, CareConcept, Travel Insurances etc.SelectYesNoWhat is the name of your insurance?* The social security number is issued by the German Pension Insurance.I'm applying for a social security number because…SelectI have not yet received a social security numberMy previous social security number has gone missingMy previous social security number is destroyedStatutory health insurance detailsName of your statutory health insurance*If you can’t find your public health insurance choose: Deutsche Rentenversicherung BUNDSelectAOK Baden-WürttembergAOK BayernAOK Bremen/BremerhavenAOK HessenAOK NiedersachsenAOK NordostAOK NordWestAOK PLUSAOK Rheinland-Pfalz/SaarlandAOK Rheinland/HamburgAOK Sachsen-AnhaltAudi BKKBAHN BKKBarmerBergische KrankenkasseBertelsmann BKKBetriebskrankenkasse MieleBIGBKK Akzo Nobel BayernBKK B. Braun AesculapBKK BPW Bergische Achsen KGBKK Deutsche Bank AGBKK DiakonieBKK EuregioBKK evmBKK eweBKK exklusivBKK Faber-Castell & PartnerBKK firmusBKK FreudenbergBKK Gildemeister SeidenstickerBKK Groz-BeckertBKK HerkulesBKK LindeBKK MahleBKK melitta hmrBKK MTUBKK PfaffBKK PfalzBKK ProVitaBKK PublicBKK PwCBKK Rieker Ricosta WeisserBKK SalzgitterBKK ScheufelenBKK Schwarzwald-Baar-HeubergBKK TechnoformBKK Textilgruppe HofBKK VBUBKK VDNBKK VerbundPlusBKK VoralbBKK Werra-MeissnerBKK Wirtschaft & FinanzenBKK WürthBKK ZF & PartnerBKK24BKK_DürkoppAdlerBMW BKKBosch BKKContinentale BetriebskrankenkasseDAK-GesundheitDebeka BKKDeutsche Rentenversicherung BUNDenergie BKKEY BKKHeimat KrankenkasseHEK Hanseatische Krankenkassehkk KrankenkasseIKK – Die InnovationskasseIKK Brandenburg und BerlinIKK classicIKK gesund plusIKK SüdwestKARL MAYER BKKKaufmännische Krankenkasse – KKHKnappschaft-Bahn-SeeKoenig & Bauer BKKKrones BKKMerck BKKmhplus BetriebskrankenkasseMobil BetriebskrankenkasseNovitas BKKPronova BKKR+V BetriebskrankenkasseSalus BKKSBK Siemens-BetriebskrankenkasseSECURVITA BKKSKD BKKSüdzucker BKKTechniker KrankenkasseTUI BKKVIACTIV Krankenkassevivida bkkWMF BetriebskrankenkasseHealth insurance numberalso called “Krankenversichertennummer” HiddenAddress Details HiddenHiddenWhat is the address of your statutory health insurance? Name Street City Email ZIP HiddenEmail Provider HiddenFax.Plus Personal informationYour Name* First Last Your Email* Enter Email Confirm Email Your Address*if your name is not on the letterbox use Address Line 2 and add: c/o “Name on the letterbox”. Street Address Address Line 2 City ZIP / Postal Code Date of birth* DD dot MM dot YYYY What was your family name / last name at birth?* What is the place/city and country of your birth?* City Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands ServiceService* Pre-filled Application Letter Pre-filled Application Letter + Sign online + We send the documents for you One-time Total Signature*Signature*Legal* I agree and require that you start the execution of the ordered service before the end of the withdrawal period. I am aware that I lose my right of withdrawal upon complete fulfillment of the contract by you. We expressly refer to our General Terms and Conditions (GTC) and the withdrawal policy, which can be viewed under the following links: GTC and withdrawal policy. Please note that we are an external service provider. For more information on data processing, please read our transparency declaration. Your application will be sent by us immediately. PaymentCredit Card*
Social Security Nr. Application Form