| Please provide details of your current address and all previous addresses to cover a continuous 5 year period. | |
| Current Address Line 1 | 2 KATSURA |
| Current Address Line 2 | |
| Current Address Line 3 | Streetly |
| Postcode | B742AR |
| From | 28/11/2019 |
| If you have been living at your current address for less than 5 years, please add more addresses below | |
| Previous Address (1) | |
| Address Line 1 | 18 Berkswell Road |
| Address Line 2 | |
| Address Line 3 | ERDINGTON |
| Postcode | B24 9EE |
| From | 01/05/2016 |
| To | 28/11/2019 |
| Previous Address (2) | |
| Address Line 1 | 14 Farndon Way |
| Address Line 2 | NewOscott |
| Address Line 3 | |
| Postcode | B23 5XU |
| From | 01/09/2013 |
| To | 01/05/2016 |
| Previous Address (3) | |
| Address Line 1 | |
| Address Line 2 | |
| Address Line 3 | |
| Postcode | |
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