What do I enter for place and date of name change of form DS-82?

I was married 5 years ago but did not change my legal name till recently. What do I enter for question 11 on form DS-82 for place and date of name change:

Source: http://www.us-passport-service-guide.com/what-do-i-enter-for-place-and-date-of-name-change-of-form-ds82.html

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