<!DOCTYPE html>
<html>
<head>
<title>Title of the document</title>
<style>
input {
margin: 5px 0;
padding: 5px;
}
</style>
</head>
<body>
<form action="/form/submit" method="get" autocomplete="off">
<div>
<input type="text" name="Name" placeholder="First Name" autocomplete="off">
</div>
<div>
<input type="text" id="lname" name="Surname" placeholder="Last Name" autocomplete="off">
</div>
<div>
<input type="number" name="Credit card number" placeholder="Credit card number">
</div>
<input type="submit" value="Submit">
</form>
</body>
</html>