| Please provide details of your current address and all previous addresses to cover a continuous 5 year period. | |
| Current Address Line 1 | 3 New Buildings |
| Current Address Line 2 | Boatyard Lane |
| Current Address Line 3 | Barlaston |
| Postcode | ST12 9DJ |
| From | 01/10/2021 |
| 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 | 151 Finstock Avenue |
| Address Line 2 | Blurton |
| Address Line 3 | Stoke on Trent |
| Postcode | ST3 3JU |
| From | 01/04/2004 |
| To | 01/10/2021 |
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