Interview sheet sample

Interview sheet

Customer name

MR/MS

Registration number

Initial year registration

Vehicle type

VIN

Storage date

Engine

Mileage

km (Mile)

Symptom

The steering wheel position (center) is in the wrong position.

Power steering warning lamp turns on.

The vehicle pulls to one direction.

Steering effort fluctuates (Not smooth. Abruptly. Increased. De)

Noise, Vibration

Others

(+)

First occurrence

Recently Others (+)

Frequency of occurrence

Always Under a certain conditions of Sometimes (time(s)/day)

Climate conditions

Irrelevant

Weather

Fine, Cloud, Rain, Snow, others (+)

Temperature

Hot, warm, cool, Cold, Temperature [Approx. deg.C(deg.F)]

Relative humidity

High, Moderate, Low

Road conditions

Urban are Suburb area High way

Mounting road (uphill or down hill) Rough road

Steering mode settings

Infiniti drive mode selector (), Steering mode setting (+)

Operation conditions, etc.

Irrelevant

When engine starts [Steering wheel angle (deg.), Tilt level (High / Mid /Low)]

During drivingAt constant speed driving During idling

During accelerationDuring deceleration

Traveling straightDuring cornering (right curve or left curve)

During steering [Steering wheel angle (deg.), Steering speed (High / Mid /Low),

Steering effort (Heavy / Light)]

Fully steered right or left (Road condition:)

Other conditions

Memo