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. deg. F (deg. 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