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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 for () turns ON.
□ Noise□ Vibration
□ 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 □ Urban area □ Suburb area □ Highway
□ Mountainous road (uphill or downhill) □ Rough road
Operating condition, etc. □Irrelevant
□When traction motor starts □ During idling
□ During driving □ During acceleration □ At constant speed driving
□ During deceleration
□ During cornering (right curve or left curve)
□ When steering wheel is steered (to right or to left)
Other conditions  
Vehicle equipment
Memo