| Please provide details of your current address and all previous addresses to cover a continuous 5 year period. | |
| Current Address Line 1 | 27 Killicomain Park |
| Current Address Line 2 | Portadown |
| Current Address Line 3 | Co. Armagh |
| Postcode | BT63 5JL |
| From | 10/12/2021 |
| 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 | 67 Village Walk |
| Address Line 2 | Portadown |
| Address Line 3 | Co. Armagh |
| Postcode | BT63 5TL |
| From | 30/06/1996 |
| To | 09/12/2021 |
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