Fill and Sign the Complaint Labor Form

IN THE ______________ COURT OF _____________ (County) , _________________ (State) _____________________ PLAINTIFF (Name of Plaintiff) V. CAUSE NO. _______,_______ _____________________ DEFENDANT (Name of Defendant) Complaint to Recover Overtime Compensation 1. Plaintiff, ____________________ (name of employee) , is now, and at all times relevant to this action was, a resident of ___________________ (name of county) , _____________________ (name of state) . 2. Defendant, ____________________________ (name of corporate employer) , is a corporation organized and existing under the laws of the State of ______________ (name of state) , with its principal place of business located at ____________________ ______________________________________________________________________ (address of corporate employer) , __________________ (name of city) , _____________________ (name of county) , ___________________ (name of state) , and, at all times mentioned in this Complaint, maintained a retail store at ____________ ______________________________________________________________________ (address of retail store) , ___________________ (name of city) , ________________ (name of county) , _________________ (name of state) . 3. At all times mentioned in this Complaint, Plaintiff was an employee of Defendant in its above-mentioned retail store. Plaintiff brings this action to recover unpaid minimum wages, overtime compensation, liquidated damages, attorney's fees, and costs under the provisions of section 16(b) of the Fair Labor Standards Act of 1938, as amended (29 U.S.C.A. §§ 201 et seq.), here referred to as the Act. 4. Since __________________ (begin date of employment) , Plaintiff was employed by Defendant in Defendant's store on the basis of an oral contract, whereby Plaintiff agreed to work ___________ (number) hours per week at a set and determined amount of compensation. Defendant, after entering into the employment contract with Plaintiff, required Plaintiff to work hours in excess of _________ (number) hours per week, and has failed and refused to pay compensation for the labor and hours in excess of ___________ (number) hours per week as performed by Plaintiff. 5. Defendant employer sells groceries and other produce by to the general public. Such groceries and other produce sold by Defendant Employer are shipped to Defendant via interstate commerce. Furthermore, Defendant, at all times material, had an annual gross volume of sales of not less the current minimum dollar amount of S_____________ for application of the FLSA, exclusive of excise taxes at the retail level. For this reason, Defendant, at all material times, was an enterprise engaged in commerce or in the production of goods for commerce as defined in section 3(s) of the Act (29 U.S.C.A. § 203(s)) and, for this reason, Plaintiff was employed by an enterprise engaged in commerce or in the production of goods for commerce within the meaning of the Act. 6. The records concerning the number of hours Plaintiff was required to work overtime for which Plaintiff has not been compensated are in the exclusive possession and control of Defendant, and Plaintiff does not know at this time the exact amount owing to Plaintiff. To the best of Plaintiff's knowledge, however, the amount owing to Plaintiff is at least the sum of $______________. 7. Plaintiff also seeks liquidated damages in the amount of $__________ as a result of (description of grounds for recovery of liquidated damages) ________________ ______________________________________________________________________ _____________________________________________________________________. 8. By reason of Defendant's refusal to pay overtime due Plaintiff, it has been necessary for Plaintiff to employ an attorney to prosecute this action, and a reasonable charge for Plaintiff's attorney's fees is the sum of $__________________. WHEREFORE, Plaintiff requests: 1. Judgment against Defendant in the amount of at least $_________________ for overtime compensation, plus such further amount due for overtime compensation as may be proved at the trial of this action, together with liquidated damages in an equal amount; 2. Award to Plaintiff of costs under provisions of the Fair Labor Standards Act of 1938, as amended; 3. Award to Plaintiff of attorney's fees for prosecuting this action; and 4. Such other relief as the Court deems just and proper. Respectfully submitted, _________________________ (Name of Plaintiff) By: _______________________________ (Name of Plaintiff’s Attorney) State Bar No. _____________ His Attorney OF COUNSEL: _______________________ (Name of Plaintiff’s Attorney) Post Office Box _______-_________ _______________________________ City, State, Zip Code Telephone: ______-______-_________