Interview Sheet Sample
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Interview sheet |
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Customer name |
MR/MS |
Registration number |
Initial year registration |
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Vehicle type |
VIN |
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Storage date |
Engine |
Mileage |
km (Mile) |
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Situation where malfunction is occurred |
Malfunction category |
Unable to brake Unable to release Generates abnormal sound Vehicle does not stop despite braking operation Parking brake continues breaking despite release operation Hooked at automatic release operation Vehicle slides down at automatic release operation Electric parking brake indicator lamp does not turns ON Electric parking brake indicator lamp keep turns ON Electric parking brake indicator lamp blinks Master warning lamp turns ON A text displayed on combination meter |
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Detailed symptom |
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Detailed abnormal sound |
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Select lever position |
P RN D |
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Seat belt operation |
OFF ON |
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Brake pedal status |
Not depress Depress |
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Electric parking brake status |
At release operation At braking operation During release During braking Continuously |
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Vehicle status |
Ignition switch OFF Ignition switch ON |
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Vehicle running status |
At start with shift in D-range While driving with shift in D-range When stopped with shift in D-range At start with shift in R-range While driving with shift in R-range When stopped with shift in R-range When stopped with shift in N-range When stopped with shift in P-range Low speed (while driving) Normal speed (while driving) High speed (while driving) |
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Road condition |
Steep downhill road Gentle downhill road Flat road Gentle uphill road Steep uphill road |
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Number of occupants |
5 4 3 2 1 |
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Vehicle loading condition (quantity) |
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Mechanical release history |
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Inspection result |
Self-diagnosis result |
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Battery condition |
Normal Abnormal () Not confirmed |
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Harness and connector condition |
Normal Abnormal () Not confirmed |
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Brake caliper assembly condition |
Normal Abnormal () Not confirmed |
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Rear brake pad condition |
Normal Abnormal () Not confirmed |
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Rear disc rotor condition |
Normal Abnormal () Not confirmed |
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Other condition |
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