chromium/components/test/data/autofill/heuristics/input/082_crbug_74918.html

<!-- https://personal.vanguard.com/us/CreateMessageServlet?FW_Event=evTopicSel&FW_Event2=Topic10&FW_Event3=NO_SELECTION -->
<form name="CreateMessage" method="post" action="/us/CreateMessageServlet?FW_Event=evSend&amp;handlerType=AuthSendMail&amp;pageType=CreateMessage" id="CreateMessage">
  <p>
    Use this form to send us a message that only Vanguard can view. Do not use this form to initiate account transactions or brokerage trades; we are unable to process transactions or trades submitted through this form.
  </p>
  <table>
    <tr>
      <td>
        <table>
          <tr>
            <td>
              <!--XSL:DIS-->
              <p>
                <b>Category</b>
              </p><!--EndDIS-->
            </td>
            <td colspan="3">
              <select name="TopicList" size="1" onchange="onChangeTopicSelection(document.CreateMessage.TopicList[document.CreateMessage.TopicList.selectedIndex].value, choice)">
                <option value="" selected>
                  Select one
                </option>
                <option value="Topic1">
                  Mailing Address Change
                </option>
                <option value="Topic2">
                  Fund Information
                </option>
                <option value="Topic3">
                  How to open an Account
                </option>
                <option value="Topic4">
                  IRA Inquiries
                </option>
                <option value="Topic5">
                  Money Transfer Options
                </option>
                <option value="Topic11">
                  My Personal Information
                </option>
                <option value="Topic6">
                  Question about a Transaction
                </option>
                <option value="Topic7">
                  Statements
                </option>
                <option value="Topic8">
                  Tax Related
                </option>
                <option value="Topic9">
                  Web Account Access
                </option>
                <option value="Topic10" selected>
                  Other
                </option>
              </select>
            </td>
          </tr>
          <tr>
            <td>
              <!-- XSL: DIS v1.00 -->
              <p>
                <b>From</b>
              </p><!-- End of chunk -->
            </td>
            <td>
              <input type="text" name="Name" size="32" maxlength="100" value="">
            </td>
            <td nowrap>
              <!-- XSL: DIS v1.00 -->
              <p>
                <b>Daytime Phone</b>
              </p><!-- End of chunk -->
            </td>
            <td nowrap>
              <input type="text" name="DayPhone" size="20" maxlength="30" value="">
            </td>
          </tr>
          <tr>
            <td>
              <!-- XSL: DIS v1.00 -->
              <p>
                <b>Subject</b>
              </p><!-- End of chunk -->
            </td>
            <td>
              <input type="text" name="Subject" size="32" maxlength="100" value="">
            </td>
            <td nowrap>
              <!-- XSL: DIS v1.00 -->
              <p>
                <b>Evening Phone</b>
              </p><!-- End of chunk -->
            </td>
            <td>
              <input type="text" name="EvePhone" size="20" maxlength="30" value="">
            </td>
          </tr>
          <tr>
            <td>
              <!-- XSL: DIS v1.00 -->
              <p>
                <b>Account</b>
              </p><!-- End of chunk -->
            </td>
            <td colspan="3">
              <select name="AccountList" size="1" onchange="onChangeSelection(document.CreateMessage.AccountList[document.CreateMessage.AccountList.selectedIndex].value)">
                <option value="NO_SELECTION" selected>
                  Select one
                </option>
                <option value="Other">
                  Other
                </option>
                <option value="None">
                  None
                </option>
              </select>
            </td>
          </tr>
          <tr>
            <td nowrap>
              <!-- XSL: DIS v1.00 -->
              <p>
                <b>E-Mail Address</b>
              </p><!-- End of chunk -->
            </td>
            <td colspan="2">
              <a href="javascript:Redirect_Close('/us/MPEmailAddress01')"></a>
              <p>
                Update your e-mail address.
              </p>
            </td>
          </tr>
        </table>
      </td>
    </tr>
    <tr>
      <td>
        <textarea name="BodyText" cols="40" rows="6" wrap="soft" onkeyup="validateLength(this, 4096)" onchange="validateLength(this, 4096)">
</textarea>
      </td>
    </tr>
  </table><input type="hidden" name="n" value="v"> <input type="hidden" name="Email" value=""> <input type="hidden" name="SelectedPlan" value="null">
</form>