How to say put down your name and address here. in Japanese

1)ここへno dictionary result, likely a conjigated verbno dictionary result, likely a conjigated verb住所住所(juusho) (n) address/residence/domicileと(to) (prt,conj) if/when/and/with/particle used for quoting/quoting particle/ promoted pawn/ indicates question名前名前(namae) (n) name/full name/given name/first nameを(wo) (prt) indicates direct object of action/indicates subject of causative expression/indicates an area traversed/indicates time over which action takes place/indicates point of departure or separation of action/indicates object of desire, like, hate,お(o) (int) oh!/polite prefix to the next word書きno dictionary result, likely a conjigated verbno dictionary result, likely a conjigated verbくださいください(kudasai) (exp) please give me/please do for me。(。) Japanese period "."    
kokohe juusho to namae woo kaki kudasai 。
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2)ここにここに(kokoni) (adv) individually/separately御住所no dictionary result, likely a conjigated verbno dictionary result, likely a conjigated verbとおとお(too) (adj-no) distant名前名前(namae) (n) name/full name/given name/first nameを(wo) (prt) indicates direct object of action/indicates subject of causative expression/indicates an area traversed/indicates time over which action takes place/indicates point of departure or separation of action/indicates object of desire, like, hate,お(o) (int) oh!/polite prefix to the next word書きno dictionary result, likely a conjigated verbno dictionary result, likely a conjigated verbくださいください(kudasai) (exp) please give me/please do for me。(。) Japanese period "."    
kokoni gojuusho too namae woo kaki kudasai 。
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