| Please provide details of your current address and all previous addresses to cover a continuous 5 year period. | |
| Current Address Line 1 | Lilac Cottage |
| Current Address Line 2 | Lees Road |
| Current Address Line 3 | Stanton-In-The-Peak |
| Postcode | DE4 2LS |
| From | 03/02/2021 |
| 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 | 16 Lea Road |
| Address Line 2 | Lea Bridge |
| Address Line 3 | Matlock |
| Postcode | DE4 5AH |
| From | 15/12/2015 |
| To | 02/02/2021 |
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| Previous Address (3) | |
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