CONSENT TO BECOME A PARTY PLAINTIFF


Salutation:
First Name:
Middle Initial:
Last Name:
Suffix (Jr, Sr):
Address:
City:
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Home Phone: (Ex.555-555-5555)
Work Phone: (Ex.555-555-5555)
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Verify Email:

I worked for Cornerstone America, a division of Mid-West National Life Insurance Company of Tennessee, as District, Regional, Area, or National sales leader/manager from
  to   Present

I understand that a lawsuit has been brought under the Fair Labor Standards Act. I have read and I understand the Notice accompanying this Consent to Become a Party Plaintiff. I understand that if I consent to become a Plaintiff and should Plaintiffs prevail, I may receive an award based on unpaid overtime wages and attorneys’ fee. I further understand that I may be liable for damages and attorneys’ fees should Defendants prevail on any counterclaim asserted against me. As a former or current District, Regional, or Area sales manager/leader for Cornerstone, I consent to become an opt-in plaintiff in the lawsuit and I agree to be bound by any judgment of this Court in this lawsuit, whether favorable or unfavorable.
I AGREE
 
I understand and agree to designate the class representatives as my agents and understand that I will be bound by the decisions and agreement made by and entered into by said representatives.
I AGREE
 
I understand that I will be represented by Watts Law Firm, L.L.P. and Jordan, Houser & Flournoy and that this Court has retained jurisdiction to determine the reasonableness of any settlement with the Defendants and any agreement concerning the reasonableness of any attorneys’ fees and costs that are to be paid to the plaintiffs’ counsel.
I AGREE