chromium/chrome/test/data/autofill/functional/crowdsourcing-test.html

<!DOCTYPE html>
<html>
  <head>
    <meta charset="UTF-8">
    <title>Autofill Crowdsourcing Test</title>
  </head>
  <body>
    <form action="http://www.google.com/" method="post" id="testform">
      <label for="fn">Fn:</label> <input type="text" id="fn"/><br/>
      <label for="ln">Ln:</label> <input type="text" id="ln"/><br/>
      <label for="em">Em:</label> <input type="text" id="em"/><br/>
      <input type="submit" value="send">
    </form>
  </body>
</html>