| Please provide details of your current address and all previous addresses to cover a continuous 5 year period. | |
| Current Address Line 1 | 3 Countess Drive |
| Current Address Line 2 | Walsall |
| Current Address Line 3 | |
| Postcode | WS4 1HT |
| From | 13/08/2021 |
| 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 | 84 Chester Road |
| Address Line 2 | Brownhills |
| Address Line 3 | |
| Postcode | WS8 6DU |
| From | 10/12/2012 |
| To | 13/08/2021 |
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| Previous Address (3) | |
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