I do hereby certify, that [blank] hath voluntarily taken and subscribed the affirmation of allegiance and fidelity ...
Contributors: Pennsylvania.
Series: Early American imprints -- no. 15519.
Publisher: Printed by John Dunlap.
Published: 1777
Place of publication: [Philadelphia]
Language: eng
Format: Microform
Subjects: Loyalty oaths -- Pennsylvania.
Notes: Blank form for a loyalty oath mandated by an act of the General Assembly passed June 13, 1777.

Place and date of publication supplied by Evans.

Evans 15519.

Microfiche. [New York : Readex Microprint, 1985] 11 x 15 cm. (Early American imprints. First series ; no. 15519)