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Jake Blumstein, Esq.
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Please respond to the questions below to help us better evaluate your potential claim:
1. What type of claim(s) are you interested in pursuing? (Check all that apply)
Please note that we are only currently taking these types of claims:
Minimum Wage
Overtime
Tipped Wages
Misclassified at Independent Contractor
Misclassified as Salaried Employee
BIPA (Biometric Privacy)
WARN Act
2. Briefly state your Job Title and Duties:
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3. What field of work best describes your job? (select one)
Restaurant and Bar Industry
Delivery Driver/Courier
Construction Worker
Office Worker
Customer Service Representative/Call Center
Mortgage Lender
Assistant Manager/Retail Employee
Other
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4. How long have you worked for the employer? (Check one)
Less than 6 months
6 - 12 months
1 - 2 years
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5. Roughly, how many people are employed by the business (including all locations)? (select one)
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6. Are your coworkers experiencing the same issue?
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7.How are you paid? (select all that apply)
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8. How many hours a week do you regularly work? (select one)
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10. How can we help you? Please explain
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where you believe the legal issue lies within the criteria stated above:
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11. Briefly describe your desired outcome:
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12. Are you willing to be a class or collective action representative?
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Possibly, but not really sure what that means
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For Illinois Workers:
Do you have to scan your fingerprint, face, eyes, or hand to access any work equipment? (Select one only if you work in Illinois)
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