| Please provide details of your current address and all previous addresses to cover a continuous 5 year period. | |
| Current Address Line 1 | 51 Manor Lane |
| Current Address Line 2 | Harlaston |
| Current Address Line 3 | Tamworth |
| Postcode | B79 9 JS |
| From | 15/01/2021 |
| 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 | 92 Argyle Street |
| Address Line 2 | Tamworth |
| Address Line 3 | |
| Postcode | B77 3EN |
| From | 01/07/2011 |
| To | 14/01/2021 |
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