| Please provide details of your current address and all previous addresses to cover a continuous 5 year period. | |
| Current Address Line 1 | 100A Ballynure Road |
| Current Address Line 2 | |
| Current Address Line 3 | Ballyclare |
| Postcode | BT39 9AQ |
| From | 30/06/2021 |
| 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 | 40 Grange Valley Avenue |
| Address Line 2 | |
| Address Line 3 | Ballyclare |
| Postcode | BT39 9FD |
| From | 01/08/2017 |
| To | 29/06/2021 |
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