Form Thanks 2

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Your information has been submitted for review.

Name*
First Last
Zip Code*
Email*
Phone
May we contact you by text message?
- Yes
- No
What type of work do you do?
Do you work more than 40 hours a week?
- Yes
- No
Are you paid time and a half if you work more than 40 Hours a week?
- Yes
- No
How are you paid?
Case Details
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