| Please provide details of your current address and all previous addresses to cover a continuous 5 year period. | |
| Current Address Line 1 | Cedar Croft |
| Current Address Line 2 | Cliffe Lane |
| Current Address Line 3 | Great Harwood |
| Postcode | BB6 7PG |
| From | 01/01/2018 |
| 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 | 5 Waltham Close |
| Address Line 2 | Baxenden |
| Address Line 3 | |
| Postcode | BB5 2TP |
| From | 22/06/1993 |
| To | 01/01/2018 |
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