weight; hair and sto talort addrems of any permanent roddonts and tecichedt of eny curront tomporary rositioncri, within the state or out of state, IncludIng • rural tout* addrou and a post office bot; arry olectronic mad address and any fr/stant messet* nome niquIrod to ba provided ptesuent to peragraph (4)(d1; date