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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.
□Warning lamp turns ON.
□Noise □Vibration
□Others
(____)
First occurrence □Recently □Others (____)
Frequency of occurrence □Always □Under certain conditions □Sometimes (time(s)/day)
Climate conditions   □Irrelevant
Weather □Fine □Cloud □Rain □Snow □Others (____)
Temperature □Hot □Warm □Cool □Cold □Temperature [Approx. °C (°F)]
Relative humidity □High □Moderate □Low
Road conditions □Urban area □Suburb area □Highway
□Mountain road (uphill or downhill) □Rough road
Operation conditions, etc. □Irrelevant
□When engine starts □During idling
□During driving □During acceleration □At constant speed driving
□During deceleration □During cornering (right curve or left curve)
□During steering
Other conditions  
Memo