DepartmentDoctors
TitleMiss
NameHimgauri Bhushan Sabnis
Date of Birth21/06/1977
GenderFemale
Ni NumberSJ835806C
Address History (Must date back 5 years)208, Dosti Ambrosia,
Dosti Acres, Wadala Antop Hill,
Mumbai, Maharashtra 400037
India
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Date from (Address 1)01/06/2018
Date to (Address 1)17/11/2023
Address 2The Elms,
Mill Lane, Hartle Wespal,
Hook, Hampshire RG270BQ
United Kingdom
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Date from (Address 2)15/03/2015
Date to (Address 2)01/06/2018
Address 318, Regent Street,
Albert Promenade
Halifax, West Yorkshire HX6 0HD
United Kingdom
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Date from (Address 3)01/04/2014
Date to (Address 3)15/03/2015
Place of BirthAhmedabad
CountryIndia
NationalityIndian
Nationality at birthIndian
Surname at birthEkbote
Used until16/03/2003
Previous Names (If applicable you must provide evidence of this – see below)Himgauri Ulhas Ekbote
Date from21/06/1977
Date to16/03/2003
Reason WhyMaiden name- changed at the time of marriage
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
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Disclosure Check Consent

Consent I confirm
Signature
Date17/11/2023