| Please provide details of your current address and all previous addresses to cover a continuous 5 year period. | |
| Current Address Line 1 | 79 Ellastone Way |
| Current Address Line 2 | Amington Green |
| Current Address Line 3 | Tamworth |
| Postcode | B77 4FT |
| From | 07/09/2021 |
| 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 | 15 Katmandu Road |
| Address Line 2 | Bromsgrove |
| Address Line 3 | |
| Postcode | B60 2SP |
| From | 14/07/2005 |
| To | 06/09/2021 |
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