Thank You
Thank you for filling out our Quick Case Evaluation form. Your information has been sent to one of our specialists.
Based on your answers, it appears that you may be entitled to unpaid overtime wages.
Please consider completing a more detailed questionnaire which will enable us to better evaluate your potential claim and respond to you more quickly:
Case Evaluation Form |
| The fields marked with a red asterisk * are required to submit this form; however the more information you provide, the better able we will be to evaluate your situation and promptly respond. So, please answer as many questions as you can. |
| May we contact you by text message?: | Yes No |
| Approximate number of employees with your job title or similar duties: |
| Employment Start Date. (If actual date is unknown, please select the first day of the month and the year you were hired):
(mm/dd/yyyy) |
| Employment End Date. (Leave blank if you are still employed with the same company. If actual date is unknown, please select the first day of the correct month and year):
(mm/dd/yyyy) |
| On average, how many hours per week do you work? (example: 45, 50, 61; not 50-60): |
| How are you paid?: |
| How much are you paid? dollars per (If paid a salary, give gross weekly, monthly, or yearly amount) |
| Are you paid time and a half if you work more than 40 hours a week? :
Yes No |
| How is Overtime paid?: |
| If you were paid for your overtime, are your bonuses, shift differential and/or other incentive pay included when your employer calculates your overtime pay rate?:
Yes No Don’t Know |
| Please briefly describe your primary job duties and responsibilities.: |
| Do you supervise two or more full-time employees? :
Yes No |
| Can you hire or fire employees? :
Yes No |
| Do you make suggestions and recommendations as to the hiring, firing, or promotion of other employees that are/were given particular weight? :
Yes No |
| Do you discipline employees? :
Yes No |
| Are you given Comp Time instead of Overtime pay? :
Yes No |
| During the last 3 years, were you paid time and a half for overtime at your prior job(s)? :
Yes No |
| Additional Information and/or your comments.: |
| Submitting this form does not establish an attorney client relationship and does not obligate this firm to represent you. We may or may not be able to undertake representation on your behalf, but we will gladly review the information you provide and respond to you. The information contained on this site is not and is not intended to be legal advice. You should always consult an attorney for individualized advice about your particular situation. I have read and understand the above. :
Yes No |
| Periodically, our firm will send out information regarding important legal news or issues that we believe may be of interest to you and your family. Would you like to be added to our mailing list? :
Yes No |
| If you searched for this site through the Web what terms/keywords did you use to find us?: |
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