1 Any Attorney or Party

Any Street
2 Any Town, CA 99999

3 555-555-5555

4 Any attorney or party

5

6

7

8 Superior Court of the State of California

9 For the County of ____________

10

11 Any Plaintiff, ) Case No.
)
12 Plaintiff, )
) UNLIMITED CIVIL, DEMAND OVER $25,000
13 vs. )
) 1. WILLFUL FAILURE TO PAY
14 Any Defendant, Does 1-50, inclusive, ) EMPLOYEE;
) 2. FAILURE TO PAY OVERTIME
15 Defendants. ) COMPENSATION;
) 3. VIOLATION OF LABOR CODE § 510 ET
16 ) SEQ;
) 4. VIOLATION OF LABOR CODE § 226.7;
17 ) 5. VIOLATION OF LABOR CODE § 203.1;
) 6. VIOLATION OF BUSINESS AND
18 ) PROFESSIONS CODE § 17200 et. seq.
)
19 )
)
20 )
)
21 )
)
22 )
)
23

24
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25

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address. Be sure to remove this notice and all other notices before
28

- 1 -
COMPLAINT
1

2 using this document.
3 Plaintiff, _________________, hereby complains and alleges as follows:
4
1. Plaintiff, __________________(hereinafter referred to as Plaintiff) is and at all times
5
mentioned herein was, an individual, over the age of majority, residing in the City of _________,
6

7
County of _________, State of California.

8 2. Defendant ______________, (hereinafter referred to as Defendant) upon

9 information and belief, is now, and at all times mentioned herein was, a corporation, organized and
10
existing under the laws of the State of California, doing business in City of _________, County of
11
_________, State of California.
12
3. This court is the proper court for trial in this action in that the actions and omissions of
13

14 Defendant as alleged herein were made within this Court’s jurisdictional area.

15 4. Plaintiff is unaware of the true names or capacities, whether they are individuals or
16
business entities, of Defendant DOES 1 through 50, and therefore sues them by such fictitious
17
names and will seek leave of this Court to insert true names and capacities once they have been
18
ascertained.
19

20 5. At all times mentioned herein, Defendants, and each of them, inclusive of DOES

21 1 through 50, were authorized and empowered by each other to act, and did so act, as agents of each
22
other, and all of the things herein alleged to have been done by them were done in the capacity of
23
such agency. Upon information and belief, all Defendants are responsible in some manner for the
24
events described herein and are liable to Plaintiff for the damages they have incurred.
25

26 FACTS COMMON TO ALL CAUSES OF ACTION

27 6. Plaintiff went to work for Defendant on or about ________________.
28
7. Plaintiff was paid by Defendant the sum of $____ per hour, on several occasions

- 2 -
COMPLAINT
1
Plaintiff was paid by the job.
2

3 8. Plaintiff worked for Defendant performing ______________________ but the entire

4 time they worked for Defendant, they were regularly and systematically required to work in excess of
5 eight hours and sometimes twelve hours per day and forty hours per week without receiving any
6
overtime compensation therefore. Plaintiff was required to wear a uniform provided by Defendant
7
during the entire time they were employed by them, they were told that they had to finish a particular
8

9
job in so many hours, one day, etc. Further Defendant supplied the tools and supplies for Plaintiff and

10 supervised their work.

11 9. Similarly, despite working at least eight hours on each day of work, Defendant did not
12
always allow Plaintiff to take a meal break as required by law.
13
10. Furthermore, Plaintiff was never allowed to take any statutorily mandated rest breaks
14
during the entire time they were employed by Defendant. Further, in or about _____ Plaintiff was told
15

16 by Defendant that if a city representative came to the job site where they were working that they were

17 to tell them they were an employee of Defendant and were being paid $____ per hour.
18
To purchase the entire document visit:
19

20 https://legaldocspro.myshopify.com/products/sample-california-
21
complaint-for-unpaid-wages-failure-to-pay-overtime-or-provide-meal-
22

23
or-rest-breaks
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- 3 -
COMPLAINT

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