| Please provide details of your current address and all previous addresses to cover a continuous 5 year period. | |
| Current Address Line 1 | 1 Sycamore Drive |
| Current Address Line 2 | Magherafelt |
| Current Address Line 3 | Magherafelt |
| Postcode | BT456FN |
| From | 30/06/2021 |
| 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 | 2 Grange Drive |
| Address Line 2 | Magherafelt |
| Address Line 3 | Magherafelt |
| Postcode | BT455RR |
| From | 04/04/2017 |
| To | 30/06/2021 |
| Previous Address (2) | |
| Address Line 1 | 1 Laurelbrook |
| Address Line 2 | Magherafelt |
| Address Line 3 | Magherafelt |
| Postcode | bt456nt |
| From | 10/05/2013 |
| To | 04/04/2017 |
| Previous Address (3) | |
| Address Line 1 | |
| Address Line 2 | |
| Address Line 3 | |
| Postcode | |
| From | |
| To |