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First Name *

Last Name *

Email *

Phone *

Employer:
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City where you worked for this employer:

State where you worked for this employer:
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Email you used in connection with this employer (if different):

Employment Start Date:

Employment End Date:

Please check if these are exact Dates:

Describe your concern briefly:

If you are an employee anywhere in the country and want to seek a consultation with us, please fill in the information below.

Our particular specialties are independent contractor misclassification, tips and service charge violations, and overtime and other wage violations.

We will do our best to respond to your inquiry as soon as possible but regret that we cannot take on all cases that are submitted. Please note that filling out this form does not create an attorney-client relationship.

Thank you!