First Name
*
Last Name
*
Pronouns (example: she/her)
*
Title (example: Ms., Mr., Mrs., Dr., etc.)
*
Email Address
*
Phone Number
*
How did you learn about SGB? (Please be specific and give the name of the attorney or law firm, if relevant)
*
Were you referred to one of our attorneys, and if so, whom?
The name of the company/organization you worked for (the one you wish to sue)
*
The US state in which the company/organization is located
*
The US state in which the company/organization is located *
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Federated States Of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
At the time your employment issue(s) arose, what state were you performing your employment duties in?
*
At the time your employment issue(s) arose, what state were you performing your employment duties in? *
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Federated States Of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
The estimated number of employees who work for the company/organization
*
Your job title/position with this employer
*
Approximately when did you begin working for this employer? (Please give the month and year)
*
Are you still currently working for this employer?
*
Are you still currently working for this employer? *
Yes
No
When is your last month working with this employer? (Example: "August 2025")
*
Have you been fired, laid off, terminated, or otherwise let go?
*
Have you been fired, laid off, terminated, or otherwise let go? *
Yes
No
Have you been demoted?
Have you been demoted?
Yes
No
Describe what your employer has done wrong.
*
What will your employer will say about your situation—even if you think it is untrue?
*
Have you complained to your employer (or HR) about your situation?
*
Have you complained to your supervisor or employer about your situation?* *
Yes
No
Have you gotten a new job with a new employer?
*
Have you gotten a new job with a new employer? *
Yes
No
Has your employer replaced you with another worker or posted an opening for your job?
*
Are you a member of a union?
*
Are you a member of a union? *
Yes
No
Have you declared bankruptcy in the last 2 years?
*
Is your employer still in business?
*
Submit