Interview sheet sample

Interview sheet

Customer name

MR/MS

Registration number

Initial year registration

Vehicle type

VIN

Storage date

Engine

Mileage

mile (km)

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□Cloudy□Rain□Snow□Others (___________________________)

Temperature

□Hot□Warm□Cool□Cold□Temperature [Approx.___________°F (°C)]

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