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FLSA OPT-IN CLAIM FORM TO RECEIVE YOUR FAIR LABOR STANDARDS ACT FLSA SETTLEMENT PAYMENT PORTION YOU MUST COMPLETE SIGN AND MAIL THIS OPT-IN CLAIM FORM BY FIRST CLASS U.S. MAIL POSTMARKED ON OR BEFORE APRIL 21 2014 TO Casas Jimenez et al. v. AT T Class Action Settlement c/o Gilardi Co. LLC. P. O. Box 1110 Corte Madera CA 94976-1110 PART I CLAIMANT INFORMATION The name and mailing address that we have for you is Make any address corrections here Name Address City State Zip State all names...
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How to fill out flsa opt-in claim form

01
Read the instructions on the FLSA opt-in claim form carefully.
02
Provide your personal information including your name, address, and contact information.
03
Ensure you have the correct case number or information relating to the FLSA claim.
04
Specify the time period during which you worked for the employer.
05
List the job duties and positions you held during the relevant time period.
06
Calculate the number of hours worked each week and indicate the regular rate of pay.
07
Provide any additional information or documentation that supports your claim.
08
Sign and date the form.
09
Submit the completed form to the appropriate authority or court.

Who needs flsa opt-in claim form?

01
Employees who believe they have been subjected to FLSA violations by their employers.
02
Individuals who wish to join a collective action or lawsuit regarding FLSA violations.
03
Workers who have evidence of unpaid wages, overtime, or other FLSA violations.
04
Employees who meet the specific criteria outlined in the FLSA opt-in claim process.
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The FLSA opt-in claim form is a document used by individuals to join an existing lawsuit or collective action under the Fair Labor Standards Act (FLSA).
Employees who wish to participate in a collective action lawsuit under the FLSA are required to file the opt-in claim form.
To fill out the FLSA opt-in claim form, individuals typically need to provide their contact information, details about their employment, and consent to join the lawsuit.
The purpose of the FLSA opt-in claim form is to allow employees to join together in a collective action to recover unpaid wages or other violations of the FLSA.
The FLSA opt-in claim form typically requires information such as the individual's name, contact information, job title, description of job duties, and dates of employment.
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