Overtime and Minimum Wage Case Evaluation

Please understand that providing information does not mean that the FairLaw Firm has taken or will take your case. However, all information will remain confidential.

About You
Your Name*
First Last
Best Telephone Number To Reach You*
Best Email Address To Reach You*
Your Current Address
Street Address Address Line 2 City State ZIP Code
Your Work:
Who is the employer (name of the employer)?
What Is The Address of Your Employer?
Street Address Address Line 2 City State ZIP Code
When Did You Start Working There?
Date Format: MM slash DD slash YYYY
How Did Your Employer Keep Time Records?
- None
- Clock
- Sign-In Sheet
- Computer
How Were You Paid?
- Salary
- Hourly
- Check
- Direct Deposit
- Cash
What Was Your Job Title or What Kind Of Work Did You Do?
Did You Spend Time Supervising Other Employees?
- Yes
- No
Are You Still Working There?
- Yes
- No
If Not, Then When Was Your Last Day Of Work?
Date Format: MM slash DD slash YYYY
Why Are You Not Working There Anymore?
Minimum Wage Questions
Check all that apply
- Paid Less Than $7.67/Hour in 2012
- Paid Less Than $7.79 in 2013
- Paid Less Than $7.93/Hour in 2014
- Paid Less than $8.05/Hour in 2015 or 2016
- Told that you were "exempt" from overtime
- Had tip pool shared with managers/cooks/others
- Not reimbursed for uniforms or other expenses
- Paid as an independent contractor
Overtime Questions
Have You Worked More Than 40 Hours A Week During The Past Two (2) Years?
- Yes
- No
Did You Get Paid Overtime (Time And One-Half) For All Hours Worked Over 40?
- Yes
- No
How Many Overtime Hours Over 40 Did You Usually Work Per Week?
Check All That Apply:
- You were denied overtime pay because you did not get pre-approval to work overtime.
- You had a lunch break automatically deducted
- You were required to work off the clock by your employer.
- You were asked to work while on your lunch break, but not paid for the time.
- You were paid a bonus based on productivity, profits, company performance, or some other productivity standard(s).
- You reported to work early or stayed late for meetings that were not counted in the hours you worked in a day.
- You had your salary or wages docked for some reason.
- You worked from home (on phone calls or exchanged emails)?
- Because you were paid a salary, your employer did not keep track of your hours.
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Overtime And Minimum Wage Case Evaluation Request

ALL INQUIRIES ARE KEPT CONFIDENTIAL

The More Information You Provide, The Better Initial Evaluation You Will Receive

About You

Your Work:

Minimum Wage Questions

Overtime Questions