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.

?EPS warning lamp turns on.

□ 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. °C (°F)

Relative humidity

□ High □ Moderate □ Low

Road conditions

□ Urban area □ Suburb area □ High way

□ Mountain road (uphill or down hill) □ 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