I [blank] do acknowledge the United States of America, to be free, independent and sovereign states, and declare that the people thereof owe no allegiance or obedience to George the Third, King of Great-Britain ...

Form of renunciation of allegiance to Great Britain, which all civil and military officers were required to sign.
Publisher and place supplied by Evans, who gives date as 1776; however, "this title ... is the revised oath of allegiance adopted Feb. 3, 1778"--Ford, P.L. Continental Congress, 165.
Evans 15183
Journals of the Continental Congress, 196
Ford, P.L. Continental Congress, 165
LC copy described is part of uncut sheet measuring 42 x 35 cm. on which are printed eight copies, imposed in quarto format with 2 copies per page; intended to be cut apart and used separately.
Also available in digital form on the Library of Congress Web site.