DepartmentDoctors
TitleDr
NameMohamed Eltom
Date of Birth01/01/1963
GenderMale
Ni NumberSP598349B
Address History (Must date back 5 years)Apartment EW 11, 1 Ellerman Wharf, Kington Street,
Hull, East Ridding of Yorkshire HU1 2BQ
United Kingdom
Map It
Date from (Address 1)04/11/2023
Date to (Address 1)02/01/2024
Address 267 Chandlers Court, Victoria Dock,
Hull, HU9 1FB
Map It
Date from (Address 2)09/10/2020
Date to (Address 2)04/11/2023
Address 3RMO Block, Flat 15, Hull Royal Infirmary,
Hull, HU3 2JZ
United Kingdom
Map It
Date from (Address 3)07/07/2014
Date to (Address 3)09/10/2020
Place of BirthMarawi
CountrySudan
NationalityBritish
Nationality at birthSudanese
Surname at birthEltom
Used until02/01/2024
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
HTML Block

Disclosure Check Consent

Consent I confirm
Signature
Date02/01/2024