autofill_creditcard_partial_form.html

<!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01//EN">
<!-- HTML credit card form used for testing Autofill preferences. -->
<html>
  <head>
 <title>Autofill Credit Card Test Form (without a name)</title>
 <meta http-equiv="Content-Type" content="text/html; charset=utf-8">
 </head>
 <body>
  <p>Autofill Credit Card Test Form (without a name)</p>
  <form id="testform" method="post">
   <table>
    <tbody>
     <tr>
      <td>
       <label for="CREDIT_CARD_NUMBER">Card Number</label>
      </td>
      <td>
       <input size="40" id="CREDIT_CARD_NUMBER" name="card_number"/>
      </td>
     </tr>
     <tr>
      <td>
       <label>Expiration Date</label>
      </td>
      <td>
       <input size="2" id="CREDIT_CARD_EXP_MONTH" name="ccmonth"> <input size="4" id="CREDIT_CARD_EXP_4_DIGIT_YEAR" name="ccyear"/>
      </td>
     </tr>
    </tbody>
   </table>
   <input type="submit" value="Submit">
  </form>
 </body>
</html>

chromium/chrome/test/data/autofill/autofill_creditcard_partial_form.html