Report a Housing Standards Issue

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26. Pspsvariables
Elements for FIRST page of form
1. 1. Login Prompt
    1. You don't have to be logged in to complete this form, but if you do have a 'My Account', log in now to retrieve your details to make filling out this form faster.
2. 2. Asterisk (* ) indicates the field must be filled in.
  3. Your Details
    1. Title:
    2. First name:*
    3. Last name:*
    4. Email address:*
    5. Confirm email address:*
    6. Contact number:*
    7. Address Details
      
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      Address lookup
      
      Address lookup
      
      Postcode:
      
      Address:
      
      My address is not listed
      
      I want to update my address manually
      
      Address manual entry
      
      Company name:
      
      Address line 1:
      
      Address line 2:
      
      Address line 3:
      
      Address line 4:
      
      Town:
      
      Postcode:
      
      INITSAVEMANUAL
      
      Your address:
      Use the address lookup to find your address or enter your address manually if it is not listed or you do not know the postcode.
    Privacy Information
    
    We collect your personal information to be able to identify you, and contact you where necessary. These details will not be used for any other purpose unless we are legally obliged to.
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