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Form Office Use Only PREVIOUS ADDRESS FORM Please complete the following form listing each address where you have lived for the past ten years and sign at the bottom of the sheet. Please list your current addres first and work backwards. Make sure you include the house and/or apartment number, street name, city, state and zip code. CURRENT ADDRESS Address City Zip State Number of years at this address: PAST ADDRESS Address City Zip State Number of years at this address: PAST ADDRESS Add.

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