chrome/test/data/autofill/heuristics/input/22_checkout_m_lowes.com.html

   1 <form id="newCreditCard">
   2     <fieldset>
   3       <legend class="hide">New Credit Card</legend>
   4
   5       <select id="ccType" name="paymentMethod" >
   6         <option value="" selected="selected">Select a card type</option>
   7         <option value="Lowes Credit Card">Lowe's Consumer Card</option>
   8
   9         <option value="VISA">VISA</option>
  10         <option value="Master Card">MasterCard</option>
  11         <option value="AMEX">American Express</option>
  12         <option value="Discover">Discover</option>
  13       </select>
  14       <div id="ccImages"></div>
  15       <input id="ccNum" name="cardNumber" type="text" placeholder="Credit card number" pattern="[0-9]*" data-maxlength="16">
  16
  17       <div class="securityCode">
  18         <input type="password" id="sCode" name="sCode" class="securityCode" placeholder="Security Code" pattern="[0-9]*" data-maxlength="4" >
  19         <a href="#" class="btn btn-tooltip slide-panel" data-element="#ccvModal" data-view="ccvModalTemplate">?</a>
  20       </div>
  21
  22       <div id="ccExpContainer">
  23         <fieldset>
  24           <legend>Expiration Date:</legend>
  25           <select name="cardExpiryMonth" id="ccExpMonth">
  26             <option value="" selected="selected">MM</option>
  27             <option value="01">01</option>
  28             <option value="02">02</option>
  29             <option value="03">03</option>
  30             <option value="04">04</option>
  31             <option value="05">05</option>
  32             <option value="06">06</option>
  33             <option value="07">07</option>
  34             <option value="08">08</option>
  35             <option value="09">09</option>
  36             <option value="10">10</option>
  37             <option value="11">11</option>
  38             <option value="12">12</option>
  39           </select>
  40           <select name="cardExpiryYear" id="ccExpYear">
  41             <option value="" selected="selected">YYYY</option>
  42           <option value="2014">2014</option><option value="2015">2015</option><option value="2016">2016</option><option value="2017">2017</option><option value="2018">2018</option><option value="2019">2019</option><option value="2020">2020</option><option value="2021">2021</option><option value="2022">2022</option></select>
  43         </fieldset>
  44       </div>
  45
  46
  47
  48     </fieldset>
  49
  50
  51
  52
  53   </form>
  54
  55