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What should an "affidavit of consent" look like? LA

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My husband and I have not filed for a legal separation. We have lived abroad for the past six years due to my employment. My husband has remained unemployed and has lived as my dependent, as well as our small son. In August I will be moving overseas for another two year tour of employment in Europe. The Italian Consulate would like a signed affidavit stating that my husband is aware that our six year old son will be residing with me overseas. What should this document look like? Could you help me with the wording?
 



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