| Please provide details of your current address and all previous addresses to cover a continuous 5 year period. | |
| Current Address Line 1 | 53 Cherwell Road |
| Current Address Line 2 | Westhoughton |
| Current Address Line 3 | Bolton |
| Postcode | BL5 3TX |
| From | 08/09/2017 |
| 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 | 2 Wingates Lane |
| Address Line 2 | Westhoughton |
| Address Line 3 | Bolton |
| Postcode | BL5 3LP |
| From | 25/11/2016 |
| To | 08/09/2017 |
| Previous Address (2) | |
| Address Line 1 | 24 Amber Drive |
| Address Line 2 | Chorley |
| Address Line 3 | |
| Postcode | PR6 0LA |
| From | 28/02/2016 |
| To | 25/11/2016 |
| Previous Address (3) | |
| Address Line 1 | |
| Address Line 2 | |
| Address Line 3 | |
| Postcode | |
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