mozilla-central/browser/extensions/formautofill/test/fixtures/third_party/Walmart/Shipping.html

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<!DOCTYPE html>
<html lang="en">
<head>
<meta name="generator" content="HTML Tidy for HTML5 for Mac OS X version 5.4.0">
<meta http-equiv="content-type" content="text/html; charset=utf-8">
<meta charset="utf-8">
<meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1">
<meta name="viewport" content="width=device-width, minimum-scale=1.0, maximum-scale=1.0, user-scalable=no">
<title>Checkout</title>
<meta property="og:type" content="Website">
<meta property="og:site_name" content="Walmart.com">
<meta property="fb:app_id" content="105223049547814">
<meta property="twitter:card" content="summary">
<meta property="twitter:site" content="@walmart">
<meta property="og:title" content="Checkout">
<meta property="twitter:title" content="Checkout">
</head>
<body>
<form>
<p>Enter new zip code:</p>
<label>
</label>
<div>
<p>
<label>ZIP Code (required)</label>
</p>
<label>
<input name="zip-code" value="" placeholder="" type="text">
</label>
</div>
<div>
<div>
<button type="submit">Calculate</button>
</div>
<div>
<button type="button">Cancel</button>
</div>
</div>
</form>
<form>
<label>
<span>
<span>Promo code
(optional)</span>
</span>
</label>
<div>
<input name="promoCode">
</div>
<button type="submit">
<span>Apply</span>
</button>
</form>
<form>
<div>
<div>
<div>
<div>
<div>*required field</div>
<label>
<span>
<span>
<span>First name*</span>
</span>
</span>
</label>
<div>
<input
title="First name" name="firstName" type="text">
</div>
<label>
<span>
<span>
<span>Last name*</span>
</span>
</span>
</label>
<div>
<input
title="Last name" name="lastName" type="text">
</div>
<label>
<span>
<span>
<span>Phone number*</span>
</span>
</span>
</label>
<div>
<input minlength="10" maxlength="14"
title="Phone number" name="phone" type="text">
</div>
</div>
<div>
<label>
<span>
<span>
<span>Street address*</span>
</span>
</span>
</label>
<div>
<input
title="Street address" name="addressLineOne" type="text">
</div>
<label>
<span>
<span>
<span>Apt, suite, etc (optional)</span>
</span>
</span>
</label>
<div>
<input
title="Apt, suite, bldg, c/o (optional)" name="addressLineTwo" type="text">
</div>
<label>
<span>
<span>
<span>City*</span>
</span>
</span>
</label>
<div>
<input
title="City" name="city" value="" type="text">
</div>
<div>
<div>
<div>
<label for="5">
<span>State*</span>
</label>
<div>
<div>
<select id="5"
title="State" name="state">
<option value="">
</option>
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DC">District of Columbia</option>
<option value="DE">Delaware</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NY">New York</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PA">Pennsylvania</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX">Texas</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VA">Virginia</option>
<option value="WA">Washington</option>
<option value="WV">West Virginia</option>
<option value="WI">Wisconsin</option>
<option value="WY">Wyoming</option>
<option value="AA">Armed Forces Americas</option>
<option value="AP">Armed Forces Pacific</option>
<option value="AE">Armed Forces other</option>
<option value="AS">American Samoa</option>
<option value="GU">Guam</option>
<option value="MP">N. Mariana Islands</option>
<option value="PW">Palau</option>
<option value="PR">Puerto Rico</option>
<option value="VI">Virgin Islands</option>
</select>
</div>
</div>
</div>
</div>
<div>
<label>
<span>
<span>
<span>ZIP
Code*</span>
</span>
</span>
</label>
<div>
<input
title="Zip code" name="postalCode" value="" type="text">
</div>
</div>
</div>
</div>
<div>
<input id="4" name="isDefault" type="checkbox">
<label for="4">
<span>Set as my preferred address</span>
</label>
</div>
</div>
</div>
</div>
</form>
</body>
</html>