wrongful termination summary

Parties to lawsuit

Plaintiff

Terminated individual

Provide facts about the terminated individual

Name

First Last

Date of birth

Marital status

Gender

Race

highest level of academic education

years of academic education

List any special licenses or skills

Date of termination

Describe conditions surrounding termination

Provide a timeline of dates relevant to termination

Pre-termination employment

Provide information about pay and benefits prior to termination

Name of employer

Start date of employment

Nature of work performed

Income ($)

Frequency of reported income:

Hours worked per week

Overtime hours worked per week

Promotions received while employed:

life insurance:

Yes

individual health insurance

Yes

family health insurance

Yes

long-term disability insurance

Yes

short-term disability insurance

Yes

employer 401k match

Yes

pension plan

Yes

bonus plan

Yes

stock option

Yes

paid vacation

Yes

other benefits

anticipated age at retirement prior to termination

Post-termination employment

Leave blank if unemployed following termination. If reemployed, provide information about pay and benefits from employment.

Name of employer

Start date of employment

Nature of work performed

Income ($)

Frequency of reported income:

Hours worked per week

Overtime hours worked per week

Promotions received while employed:

life insurance:

Yes

individual health insurance

Yes

family health insurance

Yes

long-term disability insurance

Yes

short-term disability insurance

Yes

employer 401k match

Yes

pension plan

Yes

bonus plan

Yes

paid vacation

Yes

other benefits

anticipated age at retirement following termination

Legal counsel

Provide contact information for legal counsel for the injured individual.

Name of law firm

Address*

Street Address City State / Province / Region ZIP / Postal Code

Office phone:

Facsimile

Attorney

First Last

Attorney's cell phone

Attorney's email

Paralegal / alternate contact

First Last

Paralegal's cell phone

Paralegal's email

Additional records for the injured invidual

Given the uniqueness of your client's situation, we will likely need additional information to estimation of economic damages. Please upload relevant deposition transcripts, tax returns (ideally spanning a 10-year period, but certainly the most recent return), employer handbooks detailing benefits, reports of doctors, rehabilitation specialists or vocational analysts, and information that details compensation and benefits.

deposition transcripts, tax returns, medical/worklife reports, and other relevant documents.

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Questionnaire for determination of loss associated with job termination

Parties to lawsuit

Terminated individual

Pre-termination employment

Post-termination employment

Legal counsel

Additional records for the injured invidual