| Please provide details of your current address and all previous addresses to cover a continuous 5 year period. | |
| Current Address Line 1 | 10 Springbank Avenue |
| Current Address Line 2 | Endon |
| Current Address Line 3 | Staffs |
| Postcode | ST9 9EL |
| From | 26/03/2021 |
| 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 | 15 High View Road |
| Address Line 2 | Endon |
| Address Line 3 | Staffs |
| Postcode | ST9 9HT |
| From | 14/01/2017 |
| To | 26/03/2021 |
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