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*Who else engaged in wrongdoing?

*What is your relationship to the wrongdoer(s)?

*When did you start working for this organization?

*Where do you work for this organization?

*What is your position at this organization?

*What did you earn working for this organization last year?SelectUnder $50,000$50,000 - $69,999$70,000 - $84,999$85,000 - $99,999$100,000 - $149,999$150,000 - $199,999$200,000 - $299,999$300,000 - $499,999$500,000 - $1,000,000Over $1,000,000I prefer to disclose at a later time

Do you participate in this organization’s 401(k) or pension plan?SelectYesNo

*Are you aware of any other employees who have the same or similar potential legal claims?SelectYesNo

*Have you reported the wrongdoing to anyone at this organization?SelectYesNoN/A

*Have you received any legal advice or legal representation regarding your potential legal claims?SelectYesNo

*Have you taken any legal action (e.g., sending a demand letter or filing a lawsuit) against this organization and any other wrongdoers in connection with your potential legal claims?SelectYesNo

*Have you signed any agreement (e.g., arbitration agreement or settlement agreement) related to your potential legal claims?SelectYesNo

*What was your position at this organization?

*What did you earn in your last year working for this organization?SelectUnder $50,000$50,000 - $69,999$70,000 - $84,999$85,000 - $99,999$100,000 - $149,999$150,000 - $199,999$200,000 - $299,999$300,000 - $499,999$500,000 - $1,000,000Over $1,000,000I prefer to disclose at a later time

Did you participate in this organization’s 401(k) or pension plan?SelectYesNo

*When did your employment start and end at this organization?

*Since your employment ended at this organization, have you worked for any other organizations?SelectYesNo

*Did you report the wrongdoing to anyone at this organization?SelectYesNoN/A

*Are you aware of any other employees who have the same or similar potential legal claims?SelectYesNo

*Have you received any legal advice or legal representation regarding your potential legal claims?SelectYesNo

*Have you taken any legal action (e.g., sending a demand letter or filing a lawsuit) against your former employer and any wrongdoer in connection with your potential legal claims?SelectYesNo

*Have you signed any agreement (e.g., arbitration agreement or settlement agreement) related to your potential legal claims?SelectYesNo

How many other individuals have the same or similar potential legal claims?

Are the individual(s) who have the same or similar potential legal claims interested in taking legal action against the wrongdoer(s)?SelectYesNoI don't know

Would you be able to contact the individual(s) who have the same or similar potential legal claims?SelectYesNo

*Please explain:

*Please explain:

*Please explain: