| Please provide details of your current address and all previous addresses to cover a continuous 5 year period. | |
| Current Address Line 1 | Church Lane Cottage, Church Lane |
| Current Address Line 2 | Rode |
| Current Address Line 3 | Frome |
| Postcode | BA11 6PN |
| From | 19/10/2018 |
| 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 | 198 Whiteway road |
| Address Line 2 | Speedwell |
| Address Line 3 | Bristol |
| Postcode | BS57RP |
| From | 01/01/2016 |
| To | 19/10/2018 |
| Previous Address (2) | |
| Address Line 1 | Fairoaks |
| Address Line 2 | Lyncombe Vale Road |
| Address Line 3 | Bath |
| Postcode | BA2 4LP |
| From | 01/07/1989 |
| To | 01/01/2016 |
| Previous Address (3) | |
| Address Line 1 | |
| Address Line 2 | |
| Address Line 3 | |
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