| Please provide details of your current address and all previous addresses to cover a continuous 5 year period. | |
| Current Address Line 1 | 39 Kinsey Street |
| Current Address Line 2 | Silverdale |
| Current Address Line 3 | Newcastle Under Lyme |
| Postcode | ST5 6JL |
| From | 31/07/2022 |
| 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 | Bowhill Farmhouse |
| Address Line 2 | Bowhill Lane |
| Address Line 3 | Betley |
| Postcode | CW3 9AU |
| From | 31/07/2020 |
| To | 31/07/2023 |
| Previous Address (2) | |
| Address Line 1 | 25 Chamberlain Avenue |
| Address Line 2 | Stoke On Trent |
| Address Line 3 | |
| Postcode | ST4 5EN |
| From | 01/10/2018 |
| To | 31/07/2020 |
| Previous Address (3) | |
| Address Line 1 | 3 Stavely Place |
| Address Line 2 | Silverdale |
| Address Line 3 | Newcastle Under Lyme |
| Postcode | ST5 6RN |
| From | 01/06/2000 |
| To | 01/10/2018 |