| Please provide details of your current address and all previous addresses to cover a continuous 5 year period. | |
| Current Address Line 1 | 4 Bravo Court |
| Current Address Line 2 | Bank Street |
| Current Address Line 3 | Bacup |
| Postcode | OL13 8GZ |
| From | 01/09/2020 |
| 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 | 28 Bodden Street |
| Address Line 2 | Lowton |
| Address Line 3 | Warrington |
| Postcode | WA3 1DX |
| From | 01/11/2019 |
| To | 01/09/2020 |
| Previous Address (2) | |
| Address Line 1 | 4 Bravo Court |
| Address Line 2 | Bank Street |
| Address Line 3 | Bacup |
| Postcode | OL13 8GZ |
| From | 01/08/2017 |
| To | 01/11/2019 |
| Previous Address (3) | |
| Address Line 1 | |
| Address Line 2 | |
| Address Line 3 | |
| Postcode | |
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