Got Overtime? Fill out this form for an evaluation. Please note that you must be primarily employed within the State of California

Truck Driver Form

If you drive multiple trucks, please enter the information for the largest truck that you regularly drive.

Do you currently work for the company?	Yes No
How are you paid (Check all that apply):	Hourly Daily Rate Salary Commission Piece Rate Production Bonus Other
How much do you get paid?
Approximately how many hours a week do you work?
Date you started work:
Last Day of Work (enter "Present" if currently employed.)
Job Title:
List any other significant duties other than driving?
Briefly describe the type of truck you drive (i.e. Bobtail, Box truck, tractor-trailer, etc)
Gross Weight Rating for your truck
# of Axles
Total length of truck in feet
Do you ever drive out of state?	Yes No
If you do drive out of state, how frequently do you do so?
Do you work in the moving industry?	Yes No
Do you haul any type of hazerdous waste?	Yes No
Do you personally own the truck you drive?	Yes No
Are you paid sick days?	Yes No
Are you paid holidays that you don't work?	Yes No
Are you or anyone at the company paid cash or "under the table"?	Yes No
Additional Information you want to provide:
Your Name
Your Email
Phone #
How do you prefer to be contacted:	Email Phone
What are your feelings about recovering your money?	I am ready to sue for every dime I am due. I am seriously considering litigation. I hope you can work it out without litigation. I will gather information and go forward when I am comfortable.
	If you would like a free "got overtime?" T-Shirt sent to you, please fill out the following information. This information is optional. Not all T-Shirt sizes are always available, but we will give you the closest size. We can only send T-Shirts to addresses in California. T-Shirts will only be sent when we have them in stock.
T-Shirt Size	M L XL XXL
Mailing Address

Please note that the data on this form is submitted over the internet unencrypted and is not confidential.