chromium/components/test/data/autofill/heuristics/input/040_checkout_urbanoutfitters.com.html

<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html>
	<head>

	<meta name="revisit-after" content="2 days" />
	<meta name="MSSmartTagsPreventParsing" content="TRUE" />
	<meta name="robots" content="noarchive" />
	<meta http-equiv="Pragma" content="no-cache" />
	<meta http-equiv="Expires" content="-1" />
	<meta http-equiv="Cache-Control" content="no-cache" />
	<meta name="google-site-verification" content="-bZBDubp9-_NZK9PNWE6ELnpVfFImWqHIGFsZoN9C7g" />
	
	<title>UrbanOutfitters.com > Official Site of Urban Outfitters > Shop Women's, Men's and Apartment</title>	
		<meta http-equiv="Content-Script-Type" content="text/javascript" />


</head>

<body>
		





<form action="/urban/search/search.jsp" method="GET" id="searchForm" >
							<fieldset>
							<input type="text" id="searchPhrase" name="searchPhrase" value="" />
							<input type="hidden" name="listViewSize" id="viewSize" value="" /> 
						    <input type="hidden" name="indexStart" id="viewPage" value="" />
						    <input type="hidden" name="sortBy" id="sortingBy" value=""/>
						    <input type="hidden" name="sortOrder" id="sortingOrder" value=""/>
						    <input type="hidden" name="categories" id="categories" value="" />
						    <input type="hidden" name="categories2" id="categories2" value="" />
						    <input type="hidden" name="categories3" id="categories3" value="" />
						    <input type="hidden" name="categories4" id="categories4" value="" />
						    <input type="hidden" name="skucolor" id="skucolor_normalized" value="" />
                            <input type="hidden" name="priceLow" id="priceLow" value="" />
                            <input type="hidden" name="priceHigh" id="priceHigh" value="" />
                            <input type="hidden" name="skusize" id="skusize_normalized" value="" />
                            <input type="hidden" name="brand" id="brand" value="" />
                            <input type="hidden" name="maxPrice" id="maxPrice" value="" />
                            <input type="hidden" name="minPrice" id="minPrice" value="" />
							</fieldset>
							<input id="search_submit" type="submit" value="search" />
</form>
						
			
			
			



<form id="shippingForm">
			
			<div id="shippingInformation">
				
				<div id="shippingClose">
<a >X</a>
</div>
				
				<div id="shippingContainer">
					
					<fieldset id="shipping_address_saved">
						<div>
							<h4>Select a Saved Shipping Address</h4>
							<select id="shipto" >
								<option value="">select a saved address</option>
							</select>
							<small>
<a >enter a new shipping address</a>
</small>
						</div>
					</fieldset>
					<fieldset class="address_info">
						<h4>Shipping Address</h4>
						<div class="clearLeft">
							<input value="First Name" maxlength="40" type="text" class="shippingField requiredField defaultOption" id="shippingFirstName">
						</div>
						<div>
							<input value="Last Name" maxlength="40" type="text" class="shippingField requiredField defaultOption" id="shippingLastName">
						</div>
						<div class="clearLeft" id="shippingStreetAddress">
							<input value="Street Address" maxlength="40" type="text" class="shippingFieldLong requiredField defaultOption" id="shippingAddress">
						</div>
						<p class="clearLeft" id="shippingPoBoxAddress">
							<input value="true" type="checkbox" id="shippingPobox" class="checkbox" > This address is a P.O. Box
						</p>
						<div class="clearLeft" id="shippingAddress2Apt">
							<input value="Apt / Flr / Bldg (optional)" maxlength="40" type="text" class="shippingFieldLong defaultOption" id="shippingAddress2">
						</div>
						<div class="clearLeft">
							<input value="City" maxlength="30" type="text" class="shippingField requiredField defaultOption" id="shippingCity">
						</div>
						<div id="shippingStateProvince">
							<select class="shippingFieldSelect requiredField defaultOption" id="shippingStates" >
								<option value="">State/Province</option>
							</select>
						</div>
						<p style="display: block;">
</p>
						<div class="clearLeft postalCodeDiv">
							<input value="Postal Code" type="text" class="shippingFieldPostal defaultOption" id="shippingPostalCode" maxlength="5">
						</div>
						<div>
							<select class="shippingFieldSelect requiredField defaultOption" id="shippingCountries" >
								<option value="">Country</option>
							</select>
						</div>
						<p style="display: block;">
</p>
						<div id="shippingPhoneInfo" class="clearLeft">
							<input value="Phone" type="text" class="shippingField requiredField defaultOption" id="shippingPhone" maxlength="10">
						</div>
						<div id="altShippingPhoneInfo">
							<input value="Alternate Phone (optional)" type="text" class="shippingField defaultOption" id="altShippingPhone" maxlength="10">
						</div>
						<p class="clearLeft" id="billingIsShippingCheckBox">
							<input value="true" type="checkbox" class="checkbox" id="billingIsShipping"> My billing address is the same as my shipping address
						</p>
						<p style="display: block;" id="defaultShippingCheckbox">
							<input value="true" type="checkbox" class="checkbox" id="defaultShipping" /> Make this my default shipping address
						</p>
					</fieldset>
					</div>
				<div id="shippingMethod">	
					<h4>Select a Shipping Method</h4>
					<span id="shipMethods">
</span>
					</div>
				</div>
			<!-- begin div#shippingControls -->
            <div id="shippingControls">
             	<div class="controls">
                	<a  class="modal_cancel">Cancel</a>
<a  id="shippingSave" >
<img src="#" alt="Save" height="24" width="69" />
</a>
        		</div>
            </div>
            <!-- end div#shippingControls -->
</form>








<form id="billingForm" >
			
			<div id="billingInformation">
				
				<div id="billingClose">
<a >X</a>
</div>
								
				<div id="billingContainer">
					<h4>Enter Billing Address</h4>
									
					<fieldset class="address_info">
						<div>
							<input value="First Name" maxlength="40" type="text" class="shippingField requiredField defaultOption" id="billingFirstName">
						</div>
						<div>
							<input value="Last Name" maxlength="40" type="text" class="shippingField requiredField defaultOption" size="15" id="billingLastName">
						</div>
						<div class="clearLeft" id="billingStreetAddress">
							<input value="Street Address" maxlength="40" type="text" class="shippingFieldLong requiredField defaultOption" id="billingAddress">
						</div>
						<p id="billingPoBoxAddress" class="clearLeft">
							<input value="true" type="checkbox" class="checkbox" id="billingPobox"> This address is a P.O. Box
						</p>
						<div id="billingAddress2Apt" class="clearLeft">
							<input value="Apt / Flr / Bldg (optional)" type="text" class="shippingFieldLong defaultOption" size="54" id="billingAddress2">
						</div>					
						<div class="clearLeft">
							<input value="City" maxlength="30" type="text" class="shippingField requiredField defaultOption" id="billingCity">
						</div>
						<div id="billingStateProvince">
							<select class="shippingFieldSelect requiredField" id="billingStates">
</select>
						</div>
						<p style="display: block;">
</p>
						<div class="clearLeft postalCodeDiv">
							<input value="Postal Code" type="text" class="shippingFieldPostal defaultOption" id="billingPostalCode" maxlength="5">
						</div>
						<div>
							<select class="shippingFieldSelect requiredField defaultOption" id="billingCountries" >
</select>
						</div>
						<p style="display: block;">
</p>						
						<div class="clearLeft" id="billingPhoneInfo">
							<input value="Phone" type="text" class="shippingField requiredField defaultOption" id="billingPhone" maxlength="10">
						</div>
						<div id="altbillingPhoneInfo">
							<input value="Alternate Phone (optional)" type="text" class="shippingField defaultOption" id="altBillingPhone" maxlength="10">
						</div>
						<p style="display: block" class="clearLeft" id="defaultBillingCheckbox">
							<input value="true" type="checkbox" class="checkbox" id="defaultBilling" /> Make this my default billing address
						</p>
					</fieldset>
					</div>
				<div id="billingMethod">	
					<fieldset id="creditcard_saved">
						<h4>Select Saved Credit Card</h4>
						<div>
							<select name="savedCreditCard" id="savedCreditCard" >
								<option value="">select a saved credit card</option>
							</select>
							<small>
<a >enter a new credit card</a>
</small>
						</div>
					</fieldset>
					<h4>Credit Card</h4>
					<fieldset id="creditcard_new">
						<div>
							<select name="payment_cardtype" id="payment_cardtype" class="shippingField requiredField defaultOption" >
								<option value="">Card Type</option>
								<option value="Visa">Visa</option>
						    	<option value="MasterCard">Master Card</option>			    
						    	<option value="AmericanExpress">American Express</option>
						    	<option value="Discover">Discover</option>
					    	</select>
					    	</div>				
						<div>
							<input value="Card Number (no spaces or dashes)" maxlength="16" type="text" class="shippingFieldLong requiredField defaultOption" name="payment_acctnum" id="payment_acctnum">
						</div>
						<div>
							<select name="expmonth" id="expmonth" class="shippingFieldSelect requiredField defaultOption">
								<option value="">Month</option>
								<option value="01">01</option>
								<option value="02">02</option>
								<option value="03">03</option>
								<option value="04">04</option>
								<option value="05">05</option>
								<option value="06">06</option>
								<option value="07">07</option>
								<option value="08">08</option>
								<option value="09">09</option>
								<option value="10">10</option>
								<option value="11">11</option>
								<option value="12">12</option>
							</select>													
							<select id="expyear" name="expyear" class="shippingFieldSelect requiredField defaultOption">
									<option value="">Year</option>
									<option value="2011">
						        					2011</option>
						        			<option value="2012">
						        					2012</option>
						        			<option value="2013">
						        					2013</option>
						        			<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>
						        			<option value="2023">
						        					2023</option>
						        			<option value="2024">
						        					2024</option>
						        			<option value="2025">
						        					2025</option>
						        			<option value="2026">
						        					2026</option>
						        			</select>
							</div>
						<div>
							<input value="CID / Security Code" maxlength="3" type="text" name="payment_cidnew" id="payment_cidnew" class="shippingField requiredField defaultOption">
<a  class="help_icon" id="savedCidToolTip" >
<img src="#" alt="" height="20" width="20" />
</a>
						</div>
			    		<p class="clearLeft" id="makeDefaultCreditCardCheckBox">
			    			<input value="true" type="checkbox" class="checkbox" name="makeDefaultCreditCard" id="makeDefaultCreditCard"> Make this my default credit card
						</p>
					</fieldset>
					</div>
				</div>
			<div id="billingControls">
             <div class="controls">
                	<a  class="modal_cancel">Cancel</a>
<a  id="billingSave" >
<img src="#" alt="Save" height="24" width="69" />
</a>
        		</div>
            </div>
</form>
            
            
            
      




<form name="giftMessageForm" id="giftMessageForm">
					<textarea name="giftMessageField" id="giftMessageField" maxlength="50" rows="3">
</textarea>
					<a  class="save_btn">
<img src="#" alt="Save" height="24" width="69" />
</a>
<a  class="cancel_btn">Cancel</a>
</form>










<form name="giftCardBalanceForm" id="giftCardBalanceForm">
				<input value="Gift Card Number" maxlength="16" type="text" class="defaultOption" name="giftCardNumberFromBalance" id="giftCardNumberFromBalance" />
				<input value="Gift Card PIN" type="text" class="defaultOption" name="giftCardPIN" id="giftCardPIN" />
                <input type="button" id="checkGiftCardBalanceBtn" name="checkGiftCardBalanceBtn" value="Check Balance" />
</form>





<form action="/urban/user/account_menu.jsp" name="headerlogoutForm" method="GET">
<input value="ISO-8859-1" type="hidden" name="_dyncharset">
</input>
<input value="1036725326288129983" type="hidden" name="_dynSessConf">
</input>
<input value="submit" type="hidden" name="/atg/userprofiling/ProfileFormHandler.logout">
<input value=" " type="hidden" name="_D:/atg/userprofiling/ProfileFormHandler.logout">
<input value="/urban/checkout/eco_confirm.jsp" type="hidden" name="/atg/userprofiling/ProfileFormHandler.logoutErrorURL">
<input value=" " type="hidden" name="_D:/atg/userprofiling/ProfileFormHandler.logoutErrorURL">
<a href="/urban/user/checkout_login.jsp?anonymouslogin=anonymouslogin&checkoutHeader=hide&formURL=/urban/user/account_menu.jsp" target="_top" id="utility_signin">
                                	Sign-In
                              	</a>
<input value="/urban/common/login_check.jsp" type="hidden" name="_DARGS">
</input>
</form>







<form action="/urban/common/#" name="logout" method="GET">
<input value="ISO-8859-1" type="hidden" name="_dyncharset">
</input>
<input value="1036725326288129983" type="hidden" name="_dynSessConf">
</input>
<input value="" type="hidden" name="/atg/userprofiling/ProfileFormHandler.logout">
<input value=" " type="hidden" name="_D:/atg/userprofiling/ProfileFormHandler.logout">
<input value="/urban/user/checkout_login.jsp" type="hidden" name="/atg/userprofiling/ProfileFormHandler.logoutSuccessURL">
<input value=" " type="hidden" name="_D:/atg/userprofiling/ProfileFormHandler.logoutSuccessURL">
<input value="/urban/checkout/eco_confirm.jsp" type="hidden" name="/atg/userprofiling/ProfileFormHandler.logoutErrorURL">
<input value=" " type="hidden" name="_D:/atg/userprofiling/ProfileFormHandler.logoutErrorURL">
<input value="/urban/common/login_check.jsp.1" type="hidden" name="_DARGS">
</input>
</form>



</body>
</html>