WAGE AND HOUR LAWS

OCCUPATIONS

OVERTIME QUESTIONNAIRE:


Please note: We have created a brief intake questionnaire to help us gather information about your potential case. Once, we have reviewed your questionnaire we will contact you and go into more detail with you directly. 

  • You can immediately transmit this information to our office where it will be maintained in strict confidence.
  • We will respond to your inquiry within 24 hours.


Fields marked with an * are required.

Name: *
Address:
City
State:
Zip:
E-mail:
Home Telephone: *
Work Telephone: *
Best way to reach you?

The employer against whom you may have a claim:

Employer Name: *
Dates Employed:
Est. # of Employees:

Information About Your Job:

1. Your Job Title

2. Explain your job duties

Your Wage and Payment Information

3. How were you paid?
Salary Hourly Other

Average number of hours worked per day:

Average number of hours worked per week:

Did you receive overtime for all hours worked over 8 hours in a day or over 40 hours in a week? Yes No

Did your employer keep records of the time you’ve spent working?:
Yes No

If Yes, Describe how your time was recorded (i.e. time clock, time sheets, electronic monitoring, etc.):


Are there any other comments you have that we should consider that relate to your overtime or wage claim?

Submit

QUICK CONTACT
 Full Name
 Email
 Phone
 Question

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