Interview Sheet Sample

Interview sheet
Customer name	MR/MS	Registration number	Initial year registration
Customer name	MR/MS	Vehicle type	VIN
Storage date		Engine/traction Motor	Mileage	km (Mile)
Symptom		□ Does not operate () function
		□ Warning lamp turns ON. □ or □ or □ □ □ Other ()
		□ Noise (Location:) □ Vibration (Location:)
		□ Other ()
First occurrence		□ Recently □ Other ()
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. °C (°F)]
	Relative humidity	□ High □ Moderate □ Low
Road conditions		□ Ordinary road □ Highway □ Mountainous road (uphill or downhill) □ Rough road
Operating condition, etc.		□ Irrelevant □ When engine/traction motor starts □ During idling □ During driving □ During acceleration □ At constant speed driving □ During deceleration □ Immediately before stop [Vehicle speed: Approx. km/h (MPH)] □ During cornering (right curve or left curve) □ When steering wheel is steered (to right or to left)
Other conditions	VDC OFF switch operation	□ Yes □ No
	Use of other functions (ex. ICC)	□ Yes □ No ()
	Presence of non-genuine parts installation	□ Yes □ No ()

Memo