| Please provide details of your current address and all previous addresses to cover a continuous 5 year period. | |
| Current Address Line 1 | 24 Swallowfields Drive |
| Current Address Line 2 | Hednesford |
| Current Address Line 3 | Cannock |
| Postcode | WS12 1UQ |
| From | 23/06/2021 |
| 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 | 132 Baltimore Road |
| Address Line 2 | |
| Address Line 3 | Birmingham |
| Postcode | B42 1QL |
| From | 03/11/2010 |
| To | 23/06/2021 |
| Previous Address (2) | |
| Address Line 1 | |
| Address Line 2 | |
| Address Line 3 | |
| Postcode | |
| From | |
| To | |
| Previous Address (3) | |
| Address Line 1 | |
| Address Line 2 | |
| Address Line 3 | |
| Postcode | |
| From | |
| To |