Please read the instructions to this form carefully.


We really hate to sound so stern in these instructions, but the nature of electronic communications requires us to tell you a few important things before you submit this form to us.

It is very important for you to realize that, unless you have signed a retainer agreement with the firm of K&G Law Group, PLLC we do not represent you and the fact that you are submitting the information on this questionnaire does not create any kind of contractual arrangement between you and K&G Law Group.

Your answers to the questions below are encrypted and are thus protected.  However, you should not complete this form on a computer owned by your employer or issued to you by your employer; nor should you email the firm from your work email address.

Simply stated, you should not complete this form on a computer owned by your employer or email our firm from your work email address because you have no right to privacy when using a work computer or when using an email address your employer issued to you.

If you are interested in learning more about these issues, our firm has prepared a memo entitled Old Wine in New Bottles which explains our reasoning.  If you do not have access to a computer that is secure, please call us or print the questions and answer them in a different manner.

Your Name: *

Your Email: *

Phone Number: *

Name of your Employer: *

Were you paid overtime?

Describe the situation that leads you to contact us: *

Describe how you were paid (i.e., hourly, salary) and whether you received any bonuses:

If your employer contracts with any state or local government entity, or otherwise receives any federal or state government monies (i.e., grants, etc.) please describe:

Please state your beginning and ending job title and describe any promotions, raises or awards you received:

If you are aware of any unethical, fraudulent, or dishonest dealings with the government by your former employer please describe here: