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Dostart Clapp Hannink & Coveney, LLP is located at 4370 La Jolla Village Drive, Ste. 970, San Diego, CA 92122.Tel. (858) 623-4200. Fax (858) 623-4299. Email: jclapp@broker-rights.com.

If you prefer to contact us by telephone, please call Jim Clapp at (858) 623-4200 to set up a free consultation.

Privacy Policy: All of this information will be kept strictly confidential and will not be disclosed to anyone (especially your employer) without your prior authorization.

 

 

Name:

Address:

City: State: Zip Code:

Email: Home Telephone Number:

Employer(s):

Your Job Title(s):

Your Job Duties:

How are you paid?:

Commission only Draw (repayable) plus commission

Draw (not repayable) plus commission Salary only

Salary plus commission Hourly

Other: please describe:

My employer classifies me as: An exempt employee A non-exempt employee Don't know

Do you receive overtime pay? Yes No

Do you typically earn more than $100,000 or more per year? Yes No


In the past four years, how many hours have you worked in excess of 40 hours per week,
for which you were not paid overtime?

In your job, have you incurred business-related expenses that were not reimbursed by your employer? (These may include: wages of your support staff, advertising or marketing costs, losses due to errors and omissions, licensing and registration fees, commission charge-backs, etc.)

If so, please describe these business-related expenses and estimate how much per year you have incurred:


Is there any other information we should know to properly evaluate your claim?