| Please provide details of your current address and all previous addresses to cover a continuous 5 year period. | |
| Current Address Line 1 | 14 Salters Close |
| Current Address Line 2 | Werrington |
| Current Address Line 3 | Stoke on Trent |
| Postcode | ST9 0DB |
| From | 17/11/2021 |
| 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 | 382 Cheadle Road |
| Address Line 2 | Cheddleton |
| Address Line 3 | Leek |
| Postcode | ST13 7BW |
| From | 17/11/2020 |
| To | 17/11/2021 |
| Previous Address (2) | |
| Address Line 1 | 14 Salters Close |
| Address Line 2 | Werrington |
| Address Line 3 | Stoke on Trent |
| Postcode | ST9 0DB |
| From | 25/06/2016 |
| To | 17/11/2020 |
| Previous Address (3) | |
| Address Line 1 | |
| Address Line 2 | |
| Address Line 3 | |
| Postcode | |
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