chromium/components/test/data/autofill/heuristics/input/088_crbug_98338.html

<form name="orderSummaryForm" action="#" method="post" id="orderSummaryForm">
  <div style="display:block;margin:0;padding:0;">
    <h2 id="giftcardheadline">
      victoria's secret gift card
    </h2>
    <div class="help giftcard-headline">
      <a class="offerCodeLink" href="#">Gift Card Help</a>
      <div></div>
    </div>
  </div>
  <p id="gcMessage_withEGC" style="display:none;margin:10px 0 0 0;padding:0 0 0 1px;clear:both;">
    If you have a Gift Card(s), please enter the GC Number and PIN (located on the back of the card) below.
  </p>
  <p id="gcMessage_withoutEGC" style="display:none;margin:10px 0 0 0;padding:0 0 0 1px;clear:both;">
    If you have a Gift Card(s), please enter the GC Number and PIN (located on the back of the card) below.
  </p><a name='giftcard_ref' id="giftcard_ref"></a>
  <table class="gift-card-table" border="0" cellspacing="0" cellpadding="0">
    <tr>
      <td align="left" width="732" colspan="6">
        <!-- shows the error messages for invalid giftcards -->
        <div id='giftcarderror' class="error-container"></div><!-- ends -->
      </td>
    </tr>
    <tr>
      <td colspan="6">
        <span class="giftcard-spacer">&nbsp;</span>
      </td>
    </tr>
    <tr id='gcLabel1'>
      <td>
        <label for="giftcardnumber_EGC">Gift Card Number</label>
      </td>
      <td>
        <label for="pin_EGC">PIN</label>
      </td>
      <td>
        &nbsp;
      </td>
      <td>
        &nbsp;
      </td>
      <td>
        &nbsp;
      </td>
      <td>
        &nbsp;
      </td>
    </tr>
    <tr id='gcLabel2' valign="top">
      <td>
        <input class="txt-field" type="text" name="giftcardnumber_EGC" id="giftcardnumber_EGC" value="" size="19" maxlength="19">
      </td>
      <td>
        <input class="txt-field" type="password" name="pin_EGC" id="pin_EGC" value="" size="4" maxlength="4">
        <div id="moreGCslink">
          <a href="#"><img src="#" width="69" height="22" border="0" alt="apply"></a> <a href="#"><img src="#" width="94" height="22" border="0" alt="check balance"></a>
        </div>
        <div>
          <div id="giftcard-progress-zone" style="display:none">
            <img src="#" width="32" height="11" alt="loading">
          </div>
        </div>
      </td>
      <td id="moreGCs" style="visibility: hidden;">
        <input class="txt-field" type="text" name="giftCardNumber2" value="" size="19" maxlength="19">
      </td>
      <td id="moreGCspin" style="visibility: hidden;">
        <input class="txt-field" type="text" name="giftCardPin2" value="" size="4" maxlength="4">
      </td>
      <td id="moreGCs2" style="visibility: hidden;">
        <input class="txt-field" type="text" name="giftCardNumber3" value="" size="19" maxlength="19">
      </td>
      <td id="moreGCs2pin" style="visibility: hidden;">
        <input class="txt-field" type="text" name="giftCardPin3" value="" size="4" maxlength="4">
      </td>
    </tr>
    <tr id='gcLabel1_noegc'>
      <!-- to be coded -->
      <td>
        <label for="giftcardnumber_EGC">Gift Card Number</label>
      </td>
      <td>
        <label for="pin_EGC">PIN</label>
      </td>
    </tr>
    <tr id='gcLabel2_noegc' valign="top">
      <td width="130">
        <input class="txt-field" type="text" name="giftcardnumber_GC" id="giftcardnumber_GC" value="" size="19" maxlength="19">
      </td>
      <td>
        <input class="txt-field" type="password" name="pin_GC" id="pin_GC" value="" size="4" maxlength="4">
        <div id="moreGCslink">
          <a href="#"><img src="#" width="69" height="22" border="0" alt="apply"></a> <a href="#"><img src="#" width="94" height="22" border="0" alt="check balance"></a>
        </div>
      </td>
      <td valign="middle">
        <div>
          <div id="giftcard-progress-zone2" style="display:none">
            <img src="#" width="32" height="11" alt="loading">
          </div>
        </div>
      </td>
      <td class="space27" id="moreGCs" style="visibility: hidden;">
        <input class="txt-field" type="text" name="giftCardNumber2" value="" size="19" maxlength="19">
      </td>
      <td class="space27" id="moreGCspin" style="visibility: hidden;">
        <input class="txt-field" type="text" name="giftCardPin2" value="" size="4" maxlength="4">
      </td>
      <td class="space27" id="moreGCs2" style="visibility: hidden;">
        <input class="txt-field" type="text" name="giftCardNumber3" value="" size="19" maxlength="19">
      </td>
      <td class="space27" id="moreGCs2pin" style="visibility: hidden;">
        <input class="txt-field" type="text" name="giftCardPin3" value="" size="4" maxlength="4">
      </td>
    </tr><!-- to be coded -->
    <tr>
      <td align="left" width="732" colspan="6">
        <!-- shows the messages for valid giftcards -->
        <div id='giftcardbalance' style="display:none;">
          &nbsp;
        </div><!-- ends -->
      </td>
    </tr>
  </table>
  <div class="greyline3">
    &nbsp;
    <hr>
  </div><!-- END gift card entry -->
  <div id="order-total-0"></div>
  <div id="order-total-0-noegc"></div><!--Start Credit Card Entry-->
  <div id='cc_section'>
    <h2>
      credit card information <em>(*=required)</em>
    </h2><img width="204" height="23" class="credit-cards" src="#" border="0" usemap="#cards_map">
    <table class="credit-card-table" border="0" cellpadding="0" cellspacing="0">
      <tr align="left">
        <!--td>
          Credit Card Type<span class="pink-star">*</span>
        </td-->
        <td>
          <nobr>Card Number<span class="pink-star">*</span></nobr>
        </td>
        <td>
          Expiration Month<span class="pink-star">*</span>
        </td>
        <td>
          Expiration Year<span class="pink-star">*</span>
        </td>
      </tr>
      <tr align="left">
        <td class="space27">
          <select class="select-field" id="cardType" name="cardType">
            <option value="" selected>
              select
            </option>
            <option value="Z">
              Victoria's Secret
            </option>
            <option value="V">
              Visa
            </option>
            <option value="M">
              Mastercard
            </option>
            <option value="D">
              Discover Network
            </option>
            <option value="A">
              American Express
            </option>
            <option value="J">
              JCB Card
            </option>
          </select>
        </td>
        <td class="space27">
          <input type="text" id="cardNumber" name="cardNumber" value="" class="txt-field" size="30" maxlength="20">
        </td>
        <td class="space27">
          <select name="cardMonth" class="select-field">
            <option value="" selected>
              select
            </option>
            <option value="00">
              No Expiration
            </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>
        </td>
        <td class="last">
          <select name="cardYear" class="select-field">
            <option value="" selected>
              select
            </option>
            <option value="0000">
              No Expiration
            </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>
          </select>
        </td>
      </tr>
      <tr>
        <td colspan="1">
          &nbsp;
        </td>
        <td class="detail-txt" valign="top">
          <nobr>Example: 1234567890123456</nobr>
        </td>
        <td colspan="2" class="detail-txt">
          Victoria's Secret Angel credit cards do not require an expiration date.
        </td>
      </tr>
    </table>
  </div>
  <table class="credit-card-table" border="0" cellpadding="0" cellspacing="0"></table>
  <div class="button-row">
    <div class="buttons">
      <a href="#"><img src="#" name="cancel" width="91" height="26" border="0" id="cancel"></a> <a href="#"><img src="#" width="77" height="26" border="0"></a> <a href="#"><img src="#" name="purchase" width="87" height="26" border="0" id="purchase"></a>
    </div><span class="detail-txt">Checkout pages are secured<br>
    with Secure Sockets Layer (SSL).</span>
  </div><!-- Messages for non-US shoppers -->
</form>