DepartmentDoctors
TitleDr
NameCarmen Juana Pallares Muñoz
Date of Birth05/08/1974
GenderFemale
Ni NumberSE120495D
Address History (Must date back 5 years)46 Kingsway avenue
Chorlton
Manchester, lancashire M21 9NW
United Kingdom
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Date from (Address 1)01/11/2023
Date to (Address 1)10/08/2024
Address 299 Newport Road
Chorlton
Manchester, lancashire M192Dh
United Kingdom
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Date from (Address 2)01/11/2023
Date to (Address 2)10/08/2024
Address 399 Newport Road
Chorlton
Manchester, lancashire M21 9NW
United Kingdom
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Date from (Address 3)01/11/2018
Date to (Address 3)01/11/2023
Place of BirthSanta coloma de gramanet
CountrySpain
NationalitySpanish
Nationality at birthSpanish
Surname at birthPallares Muñoz
Used until10/08/2024
Do you have any spent or unspent convictions?No
HTML BlockWe need 3 forms of ID before we can apply for your CRB. We must have 1 from Group 1 and 2 from group 2 - Please note we MUST have addressed ID! (All utility bills and Statements must be addressed to your current address)

Group 1

Valid Passport (any nationality)
UK Driving License (photo card only valid if paper part present)


Group 2

UK P45/P60 Statement (issued within last the last 12 months)
Bank or Building Society Statement (issued within the last 3 months)
Credit Card Statement (issued within the last 3 months)
UK Mortgage Statement from a recognised lender
Local council rent card or tenancy agreement (issued within the last 3 months)
Utility Bill - electric, gas, water, telephone - must be a landline bill (issued within the last 3 months), we can accept more than one utility bill as long as they are from different suppliers)
Council Tax Statement (issued within the last 12 months)
Benefit Statement, book or card; or original letter from the Department of Work and Pensions (DWP) confirming the rights to benefit – i.e child allowance, pension (issued within the last 12 months)
Confirmation from an electoral register search that a person of that name lives at claimed address (issued within the last 12 months)

Name Changes

If you have declared that you have had name changes you must provide us with evidence of this:

Marriage certificate or Civil partnership certificate Birth certificate
Adoption certificate
Divorce, dissolution or annulment papers
File
  • File
  • File
  • File
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Disclosure Check Consent

Consent I confirm
Signature
Date10/08/2024