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Interview sheet sample

Interview sheet
Customer name MR/MS Registration number   Initial year registration  
Vehicle type   VIN  
Storage date   Engine   Mileage km (Mile)
Symptom □ Vehicle does not enter AWD mode.
□ AWD warning lamp turns on.
□ Heavy tight-corner braking symptom occurs
□ Noise □ Vibration
□ Decrease in turning performance.
□ 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)
Relative humidity □ High □ Moderate □ Low
Road conditions □ Urban area □ Suburb area □ High way
□ Mounting 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)
Other conditions  

Memo