The tool wants residence city, residence county, and residence state. Apparently the registrar put place of origin instead of residence. Do I leave residence blank, or put in the Ireland and Germany countries?
I see no residence columns on this image, only the place of birth. Nothing in the place of birth column would be indexed as the residence locations.
I don't see any column for Residence on that image, only one for the Birthplace. Is there a reference image that we can't see?