FLSA information

FLSA Information

FLSA Free Case Review

Begin your FREE Review Today. Fill out the form below or call us toll free at 1-866-979-8700

This free case review form is very long and detailed. Do not feel it is required to fill out all fields and provide answers to every question. Do the best that you can. The more information we receive, the easier it is for our qualified attorneys to determine whether or not you may have a viable case.

Please click Submit only once.
Submission may take up to 1 minute.
Thank you for your patience.

Contact Information

* denotes a requied field

First Name*

Last Name

only one phone number is required

Home Phone*

- -

Work Phone*

- -

Cell Phone*

- -

Email Address*

Retype Email Address*

Street Address:

City

State/Zip

Employment Information

Employer

Employment Dates:

Start

End

Employment history with above employer:
(From most recent to least recent)

Job Position #1

Start

End

Rate of Pay

Job Position #2

Start

End

Rate of Pay

Job Position #3

Start

End

Rate of Pay

Job Position #4

Start

End

Rate of Pay

Job Position #5

Start

End

Rate of Pay

Describe your duties

Estimate the number of other employees with the same or similar job titles/positions:

Did you work overtime without pay?

Yes
No

If yes, please explain

Did you work time "off the clock" that was not recorded on your timesheet?

Yes
No

Did you pay for anything that was necessary to perform your duties, but were not reimbursed?

Yes
No

If yes, please explain

Does the company designate you as an independent contractor, but control how you perform your job?

Yes
No

If yes, please explain

Were you given a 30 minute meal period every 5 hours?

Yes
No

Were you given a 10 minute rest period every 4 hours?

Yes
No

Describe the issue/concern that you have about the employers payroll or compensation practices

	a. leaving this box checked, I agree to receive future advertisements and announcements from our firm its affiliates and partners.
	b. I agree that submitting this form and the information contained within does not establish an attorney client relationship..
	b. I agree that my information will be reviewed by more than one attorney and/or law firm.
	d. I agree that the information that I will receive in response to the above question is general information and I will not be charged for the response to this e-mail question. I further understand that the law for each state may vary, and therefore, I will not rely upon this information as legal advice. Since this matter may require advice regarding my home state, I agree that local counsel may be contacted for referral of this matter.