(1) What is your name and age?
(2) Where were you born?
(3) Where do you reside and how long have you resided there?
(4) What is your business or occupation?
(5) Give any explanation you think proper of the circumstances appearing in the testimony against you and state any facts which you think will tend to your exculpation. [Formerly 133.690; 1991 c.790 §12]