请教Maine申请表中的一段文字该如何填写？

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请教Maine申请表中的一段文字该如何填写？本人在准备申请美国Maine的CPA考试，从NASBA网站上下载了“Information for First-time Applicants.pdf”（如附件）。在文件第8页最后有一段文字描述：
State of__________________________________________ City/County of_______________________________________________
On this________________day of_________________________20____before me personally appeared__________________________
____________________________________________ to me known as the person described in and who executed the foregoing
application, who being duly sworn, did depose and say that the statements therein contained are true.
Subscribed and sworn before me the day and year aforesaid.
Notary Public______________________________
(SEAL) My commission expires______________________

有朋友告诉我这是公证处填写的内容，可是公证处表示他们不会对国外文件做公证业务且不能再国外文件上盖章。有没有申请过Maine的朋友？是否可以给些建议该如何填写这部分内容？
万分感谢！