Customer’s name

Date of purchase

Date of repair

Transmission model

Transmission

V.I.N.

Odometer reading

km (miles)

Frequency

Continuous      Intermittent (             times a day)

Weather

Fine      Cloudy      Rainy      Snowy

Others

(                                )

Place

Highland      Suburbs      Inner city      Uphill      Rough road

Others

(                                )

Ambient air temperature

Hot      Warm      Cool      Cold

Vehicle speed

km/h (MPH)

Power indicator light (AT warning light)

Blinks continuously

Does not blink

Select lever position

P     R     N     D     3     2     1

Driving condition

Not affected

When revving at a standstill

When decelerating

At starting

When accelerating

While turning ( RH/ LH)

While idling

While cruising

Power switch

ON/ OFF

Hold switch

ON/ OFF

Symptoms

No up-shift

No down-shift

No kick down

Vehicle does not move ( Any position      Particular position)

Lock-up malfunction

Noise or vibration

Shift shock or slip

Select lever does not move

Others

(                                )