Workplace Law Partners | Potential Client Questionnaire Wage And Overtime Claims

Potential Client Questionnaire Wage And Overtime Claims

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First Name
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Last Name
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Phone
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Email
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Employer Name
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Dates Of Employment (mm/dd/yyyy)
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How were you paid? (Hourly, salary, per job,etc.)
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How much were you paid?
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Did you ever get paid extra money? For example, did you also get commissions, pay for meeting goals, etc. How frequently?
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What was your job title and what were your job duties?
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Did you ever work when you were not being paid? For example, did you work while you were punched out, when you were at home, during lunch, before or after your shift, etc?
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Were you paid time and a half for working more than 40 hours in a week?
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How did your employer keep track of the hours that you worked?
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Were you paid for earned vacation when you stopped working?
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When, if ever, have you filed for bankruptcy?
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Any additional information you wish to share?
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- By checking, you agree to be contacted about your request & other information using automated technology. Message frequency varies. Msg & data rates may apply. Text STOP to cancel. SMS consent and phone number will never be shared under any circumstances. Acceptable Use Policy

Please contact us for a free consultation with one of our intake professionals (this is a screening call, not for legal advice, and we do not provide opinions over the phone) concerning whistleblower, sexual harassment, wrongful termination, overtime, discrimination, non-competes, severance agreements, unpaid wages, pregnancy discrimination, or other matters so that we can see whether our employment lawyers will be able to assist you. Our Chicago, Illinois area employment lawyers love what they do!

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First Name
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Last Name
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Phone
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Email
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Name of Employer
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Location You Worked
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Approximate Number of Employees
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Your position and general job duties/responsibilities
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Dates of Employment
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Please provide a summary of why you are seeking legal representation. It is important that you are detailed about what happened to you. Most people find it helpful to create a timeline of events beginning with when the issue began and up through the most recent events.
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Were you offered a severance?
Do you have a written employment contract?
Have you filed any complaints or charges with any government agencies?
Are there any deadlines of which you are aware? (e.g. 90-day right to sue letter; fact finding conference, etc.)
How much were you paid?
What method were you paid?
Were you injured at work?
How many hours did you typically work each week?
Have you ever been paid additional amounts beyond your regular salary or hourly wage (e.g. shift differentials, safety pay, commissions, hazard pay)?
Does your employer use any biometric data (scans of your finger, face, eyes, voice, or any other body part) for any purpose?
Has any person or entity related to your job ever required you to undergo a physical exam or asked about your family medical history (for example, questions about whether you have a history of heart disease in your family)?
Are you aware of anything illegal occurring at your job (for example, overbilling the government, lying to government?)
Does your employer have any contracts with the government or receive any government funding (e.g. Medicare, Medicaid, Department of Defense, etc.)?
If we are not able to help you, it is ok if we share your information with another law firm who may be able to help
*Upload paystubs or other relevant documents.
Please upload your resume.
- By checking this box, you agree to be contacted by text message (SMS) about your request. Message frequency varies. Msg & data rates may apply. Text STOP to cancel or text HELP for assistance. We do not share your phone number with any third parties for SMS purposes.Acceptable Use Policy