| Please provide details of your current address and all previous addresses to cover a continuous 5 year period. | |
| Current Address Line 1 | 612 Blackpool Road |
| Current Address Line 2 | Preston |
| Current Address Line 3 | |
| Postcode | PR2 1SE |
| From | 01/12/2019 |
| 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 | 31 Mount Pleasant |
| Address Line 2 | Redditch |
| Address Line 3 | |
| Postcode | B97 4HY |
| From | 01/05/2017 |
| To | 01/12/2019 |
| Previous Address (2) | |
| Address Line 1 | 2 Shottery Close |
| Address Line 2 | |
| Address Line 3 | |
| Postcode | B980GE |
| From | 01/01/2017 |
| To | 01/05/2017 |
| Previous Address (3) | |
| Address Line 1 | |
| Address Line 2 | |
| Address Line 3 | |
| Postcode | |
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