| Customer name MR/MS |
Model and Year |
VIN |
| Trans. Model |
Engine |
Mileage |
| Malfunction Date |
Manuf. Date |
In Service Date |
| Frequency |
□ Continuous □ Intermittent (times a day) |
| Symptoms |
□ Vehicle does not move. (□ Any position □ Particular position) |
| □ No up-shift (□ 1st → 2nd □ 2nd → 3rd □ 3rd → 4th □ 4th → 5th) |
| □ No down-shift (□ 5th → 4th □ 4th → 3rd □ 3rd → 2nd □ 2nd → 1st) |
| □ Lock-up malfunction |
| □ Shift point too high or too low. |
| □ Shift shock or slip (□ N → D □ N → R □ Lock-up □ Any drive position) |
| □ Noise or vibration |
| □ No kick down |
| □ No pattern select |
□ Others
() |
| A/T CHECK indicator lamp |
□ Continuously lit |
□ Not lit |
| Malfunction indicator lamp (MIL) |
□ Continuously lit |
□ Not lit |