| Please provide details of your current address and all previous addresses to cover a continuous 5 year period. | |
| Current Address Line 1 | 16 Albert Street |
| Current Address Line 2 | Padiham |
| Current Address Line 3 | |
| Postcode | BB12 8 HE |
| From | 01/05/2021 |
| 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 | 10 Lincoln Court |
| Address Line 2 | Station Road |
| Address Line 3 | Padiham |
| Postcode | BB12 8EW |
| From | 01/10/2018 |
| To | 01/05/2021 |
| Previous Address (2) | |
| Address Line 1 | 30 Gardeners Row |
| Address Line 2 | Sabden |
| Address Line 3 | |
| Postcode | BB7 9EB |
| From | 01/01/2000 |
| To | 01/10/2018 |
| Previous Address (3) | |
| Address Line 1 | |
| Address Line 2 | |
| Address Line 3 | |
| Postcode | |
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