EEOC v. Meathead Movers, Inc.

Claims Questionnaire

Employment Interest

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Submitted

Please select how you would like to access your questionnaire below.

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I Received a Class Notice

You have been identified as a potential class member and received a Class Notice by mail or email.

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I Did Not Receive a Notice

You believe you may be a class member but did not receive a Class Notice. You can still request to be considered for the settlement.

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Claims Questionnaire

Please answer all questions as accurately and completely as possible. All questions marked with * are required.

Your Progress

Question 1

What is your full legal name? *

First Name

Last Name

Question 2

What is your current mailing address? *

Street Address

City

State

ZIP Code

Country

Question 3

What is your date of birth? *

Question 4

What is your Social Security Number (last four digits only)? *

For verification purposes only.

Question 5

What is your preferred contact phone number? *

Question 6

What is your preferred email address? *

Question 7

Were you employed by or worked for the defendant during the class period? *

Question 8

Please provide the approximate dates of your employment or engagement with the defendant. *

Start Date (Approximate)

End Date (or indicate if ongoing)

Question 9

What was your job title or primary role? *

Question 10

What was your primary work location (city and state)? *

City

State

Question 11

Were you classified as an employee or independent contractor? *

Employee (W-2)

Independent Contractor (1099)

Unsure / Classification was disputed

Question 12

On average, how many hours per week did you work? *

Question 13

Did you regularly work more than 8 hours in a single workday? *

Question 14

Were you provided with meal breaks of at least 30 minutes for shifts over 5 hours? *

Yes, always

Sometimes

Rarely or never

Not applicable to my role

Question 15

Were you provided with rest breaks of at least 10 minutes for every 4 hours worked? *

Yes, always

Sometimes

Rarely or never

Not applicable to my role

Question 16

Did you receive overtime pay (1.5x your regular rate) for hours worked beyond 8 per day or 40 per week? *

Question 17

Were you required to use a personal vehicle, device, or equipment for work without reimbursement? *

Question 18

Were any deductions taken from your pay that you believed were improper or unauthorized? *

Question 19

Did you receive an itemized wage statement (pay stub) with each paycheck? *

Yes, regularly

Sometimes

Question 20

Were you paid on time and in full on each scheduled pay date? *

Yes, always

Mostly, with occasional delays

No, there were frequent issues

Question 21

Upon separation from the company, were all final wages paid within the time required by law? *

Yes

I am still employed / not applicable

Question 22

Did you file or attempt to file any internal complaint about wage or labor issues during your employment? *

Question 23

Did you experience any retaliation after raising concerns about your wages or working conditions? *

Question 24

Did you sign any arbitration agreement or class action waiver at any point during your engagement with the defendant? *

Yes

Unsure

Question 25

Have you previously filed a separate claim, lawsuit, or grievance against the defendant related to these same issues? *

Question 26

Please estimate the total approximate amount of wages or benefits you believe you are owed (if known). *

Less than $500

$500 – $2,000

$2,001 – $5,000

More than $5,000

Unknown / Unable to estimate

Question 27

Do you have any documents (pay stubs, contracts, communications, time records) that support your claim? *

Yes, I have documents available

I may have some but have not gathered them

No, I do not have documents

Question 28

Are you interested in being considered for future employment or reemployment opportunities as part of the settlement remedies? *

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Employment Interest Questionnaire

Please provide information about your employment preferences and qualifications. All fields marked * are required.

Question E-1

What type of employment are you seeking? *

Full-time employment (40+ hours/week)

Part-time employment (fewer than 40 hours/week)

Either full-time or part-time

Contract or temporary work

Question E-2

What is your current employment status? *

Unemployed and actively seeking work

Currently employed but open to new opportunities

Employed and not actively looking

Self-employed / freelancing

Question E-3

What roles or positions would you be interested in? *

Question E-4

What is the geographic area you are willing to work in? *

Local to my current address only

Within my state

Multiple states / nationwide

Remote / work from home

Question E-5

What is your highest level of education completed? *

Question E-6

How many years of relevant work experience do you have? *

Question E-7

Do you hold any professional licenses, certifications, or endorsements? *

Question E-8

What is your minimum acceptable hourly wage or annual salary? *

Question E-9

Are you available to begin work within the next 30 days if an opportunity were offered? *

Question E-10

Is there anything else you would like the settlement administrator to know about your employment interests or circumstances?

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Questionnaire Submitted

Your Claims Questionnaire has been received. The settlement administrator will review your submission and contact you if additional information is needed.

CONF-CQ-000000

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A confirmation email has been sent to the address you provided. Please retain it for your records.

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All Questionnaires Submitted

Your Claims Questionnaire and Employment Interest Questionnaire have been successfully submitted. The settlement administrator will review your submission and contact you if additional information is needed.

CONF-EIQ-000000

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Both questionnaires have been received. A confirmation email has been sent to the address you provided. Please retain this for your records.

Electronic Submissions

I Received a Class Notice

I Did Not Receive a Notice

Claims Questionnaire

Employment Interest Questionnaire

Employment Interest Questionnaire

Questionnaire Submitted

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