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Interview Sheet Sample

Interview sheet

Customer name

MR/MS

Registration number

Initial year registration

Vehicle type

VIN

Storage date

Engine/traction Motor

Mileage

km (Mile)

Symptom

Does not operate (_____) function

Warning lamp turns ON.

SYMBOL or SYMBOLSYMBOL or SYMBOLSYMBOLSYMBOLSYMBOL

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. Deg. C (Deg. 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