| Customer name MR/MS |
Engine # |
|
Manuf. Date |
|
| |
Incident Date |
|
VIN |
|
| Model & Year |
|
In Service Date |
|
| Trans. |
|
Mileage |
km/Mile |
| Symptoms |
□ Vehicle does not move (□ Any position□ Particular position) |
| □ No up-shift (□ 1GR → 2GR□ 2GR → 3GR□ 3GR → 4GR□ 4GR → 5GR□ 5GR → 6GR□ 6GR → 7GR) |
| □ No down-shift (□ 7GR → 6GR□ 6GR → 5GR□ 5GR → 4GR□ 4GR → 3GR□ 3GR → 2GR□ 2GR → 1GR) |
| □ Lock-up malfunction |
| □ Shift point too high or too low |
| □ Shift shock or slip |
| □ Noise or vibration |
| □ No kick down |
| □ No pattern select |
| □ Others |
| |
| Frequency |
□ All the time |
□ Under certain conditions |
□ Sometimes (times a day) |
| Weather conditions |
|
□ Not affected |
| |
Weather |
□ Fine |
□ Clouding |
□ Raining |
□ Snowing |
□ Other () |
| |
Temp. |
□ Hot |
□ Warm |
□ Cool |
□ Cold |
□ Temp. (Approx. °C/°F) |
| |
Humidity |
□ High |
□ Middle |
□ Low |
|
|
|
| Transmission conditions |
□ Not affected |
| □ Cold |
□ During warm-up |
□ After warm-up |
| □ Engine speed (RPM) |
| Road conditions |
□ Not affected |
| □ In town |
□ In suburbs |
□ Freeway |
□ Off road (Up/Down) |
| Driving conditions |
□ Not affected |
| □ At starting |
□ While idling |
□ While engine racing |
□ At racing |
□ While cruising |
| □ While accelerating |
□ While decelerating |
□ While turning (Right/Left) |
| □ Vehicle speed [ km/h (MPH)] |
| Other conditions |
|