DepartmentDoctors
TitleDr
NameDavid James Eagle
Date of Birth23/02/1974
GenderMale
Ni NumberJA316468A
Address History (Must date back 5 years)6 Standall Close
Dronfield Woodhouse
Dronfield, Sheffield S18 8AB
United Kingdom
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Date from (Address 1)30/06/2015
Date to (Address 1)01/04/2024
Address 26 Standall Close
Dronfield Woodhouse
Dronfield, -- Select State -- S18 8AB
United Kingdom
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Place of BirthSheffield
CountryEngland
NationalityBritish
Nationality at birthBritish
Surname at birthEagle
Used until01/04/2024
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
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Disclosure Check Consent

Consent I confirm
Signature
Date01/04/2024