form-fill-examples/basic_cc.html

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<!DOCTYPE html>
<html>
<head>
<meta charset="utf-8">
<title>Form Autofill Demo: Basic Credit Card @autocomplete</title>
<link rel="stylesheet" href="css/base.css"/>
</head>
<body>
<h1>Form Autofill Demo: Basic Credit Card @autocomplete</h1>
<form class="alignedLabels">
<label>Name: <input autocomplete="cc-name"></label>
<label>Card Number: <input autocomplete="cc-number"></label>
<label>Expiration month: <input autocomplete="cc-exp-month"></label>
<label>Expiration year: <input autocomplete="cc-exp-year"></label>
<label>CSC: <input autocomplete="cc-csc"></label>
<p>
<input type="submit" value="Submit">
<button type="reset">Reset</button>
</p>
</form>
</body>
</html>