| Please provide details of your current address and all previous addresses to cover a continuous 5 year period. | |
| Current Address Line 1 | 50 Holly Street |
| Current Address Line 2 | Stapenhill |
| Current Address Line 3 | Burton on Trent |
| Postcode | DE15 9ET |
| From | 12/08/2021 |
| 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 | 22 Townhead |
| Address Line 2 | Alton |
| Address Line 3 | Staffordshire |
| Postcode | ST10 4AW |
| From | 01/09/2019 |
| To | 11/08/2021 |
| Previous Address (2) | |
| Address Line 1 | 50 Holly Street |
| Address Line 2 | StapenhilL |
| Address Line 3 | Burton on Trent |
| Postcode | DE15 9ET |
| From | 17/02/2017 |
| To | 01/09/2019 |
| Previous Address (3) | |
| Address Line 1 | |
| Address Line 2 | |
| Address Line 3 | |
| Postcode | |
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