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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT Edit "Citizenship" value="" | [
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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT Edit "Town" value="" | [
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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT Edit "Sex" value="" | [
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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT Edit "Coupon code" value="" | [
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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT Edit "Nation" value="" | [
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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT Edit "Organization" value="" | [
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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT Edit "Known allergies" value="" | [
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"fill Allergies: Penicillin",
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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT Edit "Start date" value="" | [
"fill Case worker: Liam Fischer",
"fill Gender: Female",
"fill Allergies: Penicillin",
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"fill Business tel: 811.881.4358",
"fill Nationality: British",
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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT Edit "Next of kin" value="" | [
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"fill Gender: Female",
"fill Allergies: Penicillin",
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"fill Nationality: British",
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"fill Country of residence: Brazil",
"fill Meds: Metformin 500mg",
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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT Edit "Applicant name" value="" | [
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"fill Allergies: Penicillin",
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"fill Meds: Metformin 500mg",
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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT Edit "Medicines taken" value="" | [
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"fill Gender: Female",
"fill Allergies: Penicillin",
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"fill Contact number: +1 633 208 1384",
"fill Country of residence: Brazil",
"fill Meds: Metformin 500mg",
"fill ... | 8 | {
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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT Edit "E-mail" value="" hint="name@domain.com" | [
"fill Case worker: Liam Fischer",
"fill Gender: Female",
"fill Allergies: Penicillin",
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"fill Business tel: 811.881.4358",
"fill Nationality: British",
"fill Contact number: +1 633 208 1384",
"fill Country of residence: Brazil",
"fill Meds: Metformin 500mg",
"fill ... | 16 | {
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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT Edit "Business phone" value="" | [
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"fill Gender: Female",
"fill Allergies: Penicillin",
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"fill Nationality: British",
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"fill Country of residence: Brazil",
"fill Meds: Metformin 500mg",
"fill ... | 4 | {
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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT Edit "Primary phone" value="" | [
"fill Case worker: Liam Fischer",
"fill Gender: Female",
"fill Allergies: Penicillin",
"fill Legal name: Sofia Larsson",
"fill Business tel: 811.881.4358",
"fill Nationality: British",
"fill Contact number: +1 633 208 1384",
"fill Country of residence: Brazil",
"fill Meds: Metformin 500mg",
"fill ... | 6 | {
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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT Edit "Birth date" value="" hint="YYYY-MM-DD" | [
"fill Case worker: Liam Fischer",
"fill Gender: Female",
"fill Allergies: Penicillin",
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"fill Nationality: British",
"fill Contact number: +1 633 208 1384",
"fill Country of residence: Brazil",
"fill Meds: Metformin 500mg",
"fill ... | 16 | {
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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT CheckBox "Consent to electronic communication (required)" unchecked | [
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"fill Gender: Female",
"fill Allergies: Penicillin",
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"fill Nationality: British",
"fill Contact number: +1 633 208 1384",
"fill Country of residence: Brazil",
"fill Meds: Metformin 500mg",
"fill ... | 14 | {
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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT CheckBox "I authorize verification of the information provided" unchecked | [
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"fill Allergies: Penicillin",
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"fill Nationality: British",
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"fill Meds: Metformin 500mg",
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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT Button "Go back" value="" | [
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"fill Allergies: Penicillin",
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"fill Nationality: British",
"fill Contact number: +1 633 208 1384",
"fill Country of residence: Brazil",
"fill Meds: Metformin 500mg",
"fill ... | 16 | {
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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT Button "Clear" value="" | [
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"fill Nationality: British",
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"fill Country of residence: Brazil",
"fill Meds: Metformin 500mg",
"fill ... | 16 | {
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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT Button "Sign up" value="" | [
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"fill Country of residence: Brazil",
"fill Meds: Metformin 500mg",
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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT TitleBar "Orbit Telecom - Account Transfer - Google Chrome - JevBrowser" value="" | [
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"fill Meds: Metformin 500mg",
"fill ... | 16 | {
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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT Button "Page up" value="" | [
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"fill Nationality: British",
"fill Contact number: +1 633 208 1384",
"fill Country of residence: Brazil",
"fill Meds: Metformin 500mg",
"fill ... | 16 | {
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"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT Button "Back" value="" | [
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"fill Gender: Female",
"fill Allergies: Penicillin",
"fill Legal name: Sofia Larsson",
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"fill Nationality: British",
"fill Contact number: +1 633 208 1384",
"fill Country of residence: Brazil",
"fill Meds: Metformin 500mg",
"fill ... | 16 | {
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} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT Button "Bookmark this page" value="" | [
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"fill Allergies: Penicillin",
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"fill Nationality: British",
"fill Contact number: +1 633 208 1384",
"fill Country of residence: Brazil",
"fill Meds: Metformin 500mg",
"fill ... | 16 | {
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} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT Button "Line down" value="" | [
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"fill Allergies: Penicillin",
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"fill Nationality: British",
"fill Contact number: +1 633 208 1384",
"fill Country of residence: Brazil",
"fill Meds: Metformin 500mg",
"fill ... | 16 | {
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"action": "skip"
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TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer - Google Chrome
ELEMENT ScrollBar "Vertical" value="" | [
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"fill Nationality: British",
"fill Contact number: +1 633 208 1384",
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"fill Meds: Metformin 500mg",
"fill ... | 16 | {
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TASK fill the form from the document, then submit
FORM Form
ELEMENT Edit "Emergency phone" value="" | [
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"fill Emergency phone: (645) 244-4787",
"fill Current employer: Wonka Foods",
"fill Medications: Albuterol inhaler",
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TASK fill the form from the document, then submit
FORM Form
ELEMENT Edit "Vehicle year" value="" | [
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TASK fill the form from the document, then submit
FORM Form
ELEMENT Edit "E-mail" value="" | [
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TASK fill the form from the document, then submit
FORM Form
ELEMENT Edit "Mobile phone" value="" hint="(555) 555-5555" | [
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"fill Primary ... | 9 | {
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TASK fill the form from the document, then submit
FORM Form
ELEMENT Edit "Next of kin" value="" | [
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"fill Primary ... | 17 | {
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TASK fill the form from the document, then submit
FORM Form
ELEMENT Edit "Accident date" value="" | [
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"fill Date of birth: 20 Sep 1996",
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"fill Make: Ford",
"fill Address: 6775 Sunset Court",
"fill Primary ... | 16 | {
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TASK fill the form from the document, then submit
FORM Form
ELEMENT Edit "VIN number" value="" | [
"fill Year: 2011",
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"fill Make: Ford",
"fill Address: 6775 Sunset Court",
"fill Primary ... | 6 | {
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TASK fill the form from the document, then submit
FORM Form
ELEMENT Edit "Start date" value="" | [
"fill Year: 2011",
"fill Emergency phone: (645) 244-4787",
"fill Current employer: Wonka Foods",
"fill Medications: Albuterol inhaler",
"fill Model: F-150",
"fill Date of birth: 20 Sep 1996",
"fill Vehicle ID: UD87HN1ANSVPGEY98",
"fill Make: Ford",
"fill Address: 6775 Sunset Court",
"fill Primary ... | 20 | {
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TASK fill the form from the document, then submit
FORM Form
ELEMENT Edit "DOB" value="" hint="YYYY-MM-DD" | [
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"fill Current employer: Wonka Foods",
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"fill Model: F-150",
"fill Date of birth: 20 Sep 1996",
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"fill Make: Ford",
"fill Address: 6775 Sunset Court",
"fill Primary ... | 5 | {
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TASK fill the form from the document, then submit
FORM Form
ELEMENT Edit "Work phone" value="" | [
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"fill Make: Ford",
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"fill Primary ... | 20 | {
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TASK fill the form from the document, then submit
FORM Form
ELEMENT Edit "Policy #" value="" | [
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"fill Make: Ford",
"fill Address: 6775 Sunset Court",
"fill Primary ... | 10 | {
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TASK fill the form from the document, then submit
FORM Form
ELEMENT Edit "Manufacturer" value="" | [
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"fill Primary ... | 7 | {
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TASK fill the form from the document, then submit
FORM Form
ELEMENT Edit "First" value="" hint="First" | [
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"fill Address: 6775 Sunset Court",
"fill Primary ... | 12 | {
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TASK fill the form from the document, then submit
FORM Form
ELEMENT Edit "Postcode" value="" | [
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"fill Make: Ford",
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"fill Primary ... | 14 | {
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"role": "Edit",
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TASK fill the form from the document, then submit
FORM Form
ELEMENT Edit "Vehicle model" value="" | [
"fill Year: 2011",
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"fill Current employer: Wonka Foods",
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"fill Primary ... | 4 | {
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TASK fill the form from the document, then submit
FORM Form
ELEMENT Edit "Highest degree" value="" | [
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"fill Primary ... | 13 | {
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TASK fill the form from the document, then submit
FORM Form
ELEMENT Edit "Street address" value="" | [
"fill Year: 2011",
"fill Emergency phone: (645) 244-4787",
"fill Current employer: Wonka Foods",
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"fill Make: Ford",
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"fill Primary ... | 8 | {
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TASK fill the form from the document, then submit
FORM Form
ELEMENT Edit "Plate #" value="" | [
"fill Year: 2011",
"fill Emergency phone: (645) 244-4787",
"fill Current employer: Wonka Foods",
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"fill Make: Ford",
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"fill Primary ... | 11 | {
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TASK fill the form from the document, then submit
FORM Form
ELEMENT CheckBox "I certify the information above is accurate" unchecked | [
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"fill Emergency phone: (645) 244-4787",
"fill Current employer: Wonka Foods",
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"fill Model: F-150",
"fill Date of birth: 20 Sep 1996",
"fill Vehicle ID: UD87HN1ANSVPGEY98",
"fill Make: Ford",
"fill Address: 6775 Sunset Court",
"fill Primary ... | 18 | {
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"role": "CheckBox",
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TASK fill the form from the document, then submit
FORM Form
ELEMENT Button "Upload file" value="" | [
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"fill Medications: Albuterol inhaler",
"fill Model: F-150",
"fill Date of birth: 20 Sep 1996",
"fill Vehicle ID: UD87HN1ANSVPGEY98",
"fill Make: Ford",
"fill Address: 6775 Sunset Court",
"fill Primary ... | 20 | {
"seed": 12161,
"role": "Button",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Form
ELEMENT Button "Discard" value="" | [
"fill Year: 2011",
"fill Emergency phone: (645) 244-4787",
"fill Current employer: Wonka Foods",
"fill Medications: Albuterol inhaler",
"fill Model: F-150",
"fill Date of birth: 20 Sep 1996",
"fill Vehicle ID: UD87HN1ANSVPGEY98",
"fill Make: Ford",
"fill Address: 6775 Sunset Court",
"fill Primary ... | 20 | {
"seed": 12161,
"role": "Button",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Form
ELEMENT Button "Register" value="" | [
"fill Year: 2011",
"fill Emergency phone: (645) 244-4787",
"fill Current employer: Wonka Foods",
"fill Medications: Albuterol inhaler",
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"fill Date of birth: 20 Sep 1996",
"fill Vehicle ID: UD87HN1ANSVPGEY98",
"fill Make: Ford",
"fill Address: 6775 Sunset Court",
"fill Primary ... | 19 | {
"seed": 12161,
"role": "Button",
"action": "click"
} |
TASK fill the form from the document, then submit
FORM Form
ELEMENT Button "Bookmark this page" value="" | [
"fill Year: 2011",
"fill Emergency phone: (645) 244-4787",
"fill Current employer: Wonka Foods",
"fill Medications: Albuterol inhaler",
"fill Model: F-150",
"fill Date of birth: 20 Sep 1996",
"fill Vehicle ID: UD87HN1ANSVPGEY98",
"fill Make: Ford",
"fill Address: 6775 Sunset Court",
"fill Primary ... | 20 | {
"seed": 12161,
"role": "Button",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Form
ELEMENT ScrollBar "Vertical" value="" | [
"fill Year: 2011",
"fill Emergency phone: (645) 244-4787",
"fill Current employer: Wonka Foods",
"fill Medications: Albuterol inhaler",
"fill Model: F-150",
"fill Date of birth: 20 Sep 1996",
"fill Vehicle ID: UD87HN1ANSVPGEY98",
"fill Make: Ford",
"fill Address: 6775 Sunset Court",
"fill Primary ... | 20 | {
"seed": 12161,
"role": "ScrollBar",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Form
ELEMENT Pane "Page content" value="" | [
"fill Year: 2011",
"fill Emergency phone: (645) 244-4787",
"fill Current employer: Wonka Foods",
"fill Medications: Albuterol inhaler",
"fill Model: F-150",
"fill Date of birth: 20 Sep 1996",
"fill Vehicle ID: UD87HN1ANSVPGEY98",
"fill Make: Ford",
"fill Address: 6775 Sunset Court",
"fill Primary ... | 20 | {
"seed": 12161,
"role": "Pane",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Pinewood Camp - Parent Consent Form - Google Chrome
ELEMENT Edit "State" value="" | [
"fill Model: Outback",
"fill Town: Omaha",
"fill Printed: 2026-08-19",
"fill Postcode: 68102",
"fill Manufacturer: Subaru",
"fill Cell: 858.981.2321",
"fill Vehicle ID: J4Q4MBJP3V8G3VVGL",
"fill LinkedIn: linkedin.com/in/hannah-ortega",
"fill Known allergies: Penicillin",
"fill Role: Sales Associa... | 14 | {
"seed": 20080,
"role": "Edit",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Pinewood Camp - Parent Consent Form - Google Chrome
ELEMENT Edit "Role" value="" | [
"fill Model: Outback",
"fill Town: Omaha",
"fill Printed: 2026-08-19",
"fill Postcode: 68102",
"fill Manufacturer: Subaru",
"fill Cell: 858.981.2321",
"fill Vehicle ID: J4Q4MBJP3V8G3VVGL",
"fill LinkedIn: linkedin.com/in/hannah-ortega",
"fill Known allergies: Penicillin",
"fill Role: Sales Associa... | 9 | {
"seed": 20080,
"role": "Edit",
"action": "fill"
} |
TASK fill the form from the document, then submit
FORM Pinewood Camp - Parent Consent Form - Google Chrome
ELEMENT Edit "Highest degree" value="" | [
"fill Model: Outback",
"fill Town: Omaha",
"fill Printed: 2026-08-19",
"fill Postcode: 68102",
"fill Manufacturer: Subaru",
"fill Cell: 858.981.2321",
"fill Vehicle ID: J4Q4MBJP3V8G3VVGL",
"fill LinkedIn: linkedin.com/in/hannah-ortega",
"fill Known allergies: Penicillin",
"fill Role: Sales Associa... | 10 | {
"seed": 20080,
"role": "Edit",
"action": "fill"
} |
TASK fill the form from the document, then submit
FORM Pinewood Camp - Parent Consent Form - Google Chrome
ELEMENT Edit "Why do you want this job?" value="" | [
"fill Model: Outback",
"fill Town: Omaha",
"fill Printed: 2026-08-19",
"fill Postcode: 68102",
"fill Manufacturer: Subaru",
"fill Cell: 858.981.2321",
"fill Vehicle ID: J4Q4MBJP3V8G3VVGL",
"fill LinkedIn: linkedin.com/in/hannah-ortega",
"fill Known allergies: Penicillin",
"fill Role: Sales Associa... | 14 | {
"seed": 20080,
"role": "Edit",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Pinewood Camp - Parent Consent Form - Google Chrome
ELEMENT Edit "Next of kin phone" value="" | [
"fill Model: Outback",
"fill Town: Omaha",
"fill Printed: 2026-08-19",
"fill Postcode: 68102",
"fill Manufacturer: Subaru",
"fill Cell: 858.981.2321",
"fill Vehicle ID: J4Q4MBJP3V8G3VVGL",
"fill LinkedIn: linkedin.com/in/hannah-ortega",
"fill Known allergies: Penicillin",
"fill Role: Sales Associa... | 14 | {
"seed": 20080,
"role": "Edit",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Pinewood Camp - Parent Consent Form - Google Chrome
ELEMENT Edit "City / Town" value="Omaha" | [
"fill Model: Outback",
"fill Town: Omaha",
"fill Printed: 2026-08-19",
"fill Postcode: 68102",
"fill Manufacturer: Subaru",
"fill Cell: 858.981.2321",
"fill Vehicle ID: J4Q4MBJP3V8G3VVGL",
"fill LinkedIn: linkedin.com/in/hannah-ortega",
"fill Known allergies: Penicillin",
"fill Role: Sales Associa... | 14 | {
"seed": 20080,
"role": "Edit",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Pinewood Camp - Parent Consent Form - Google Chrome
ELEMENT Edit "Manufacturer" value="Subaru" | [
"fill Model: Outback",
"fill Town: Omaha",
"fill Printed: 2026-08-19",
"fill Postcode: 68102",
"fill Manufacturer: Subaru",
"fill Cell: 858.981.2321",
"fill Vehicle ID: J4Q4MBJP3V8G3VVGL",
"fill LinkedIn: linkedin.com/in/hannah-ortega",
"fill Known allergies: Penicillin",
"fill Role: Sales Associa... | 14 | {
"seed": 20080,
"role": "Edit",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Pinewood Camp - Parent Consent Form - Google Chrome
ELEMENT Edit "Daytime phone" value="858.981.2321" | [
"fill Model: Outback",
"fill Town: Omaha",
"fill Printed: 2026-08-19",
"fill Postcode: 68102",
"fill Manufacturer: Subaru",
"fill Cell: 858.981.2321",
"fill Vehicle ID: J4Q4MBJP3V8G3VVGL",
"fill LinkedIn: linkedin.com/in/hannah-ortega",
"fill Known allergies: Penicillin",
"fill Role: Sales Associa... | 14 | {
"seed": 20080,
"role": "Edit",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Pinewood Camp - Parent Consent Form - Google Chrome
ELEMENT Edit "Second email (optional)" value="" | [
"fill Model: Outback",
"fill Town: Omaha",
"fill Printed: 2026-08-19",
"fill Postcode: 68102",
"fill Manufacturer: Subaru",
"fill Cell: 858.981.2321",
"fill Vehicle ID: J4Q4MBJP3V8G3VVGL",
"fill LinkedIn: linkedin.com/in/hannah-ortega",
"fill Known allergies: Penicillin",
"fill Role: Sales Associa... | 14 | {
"seed": 20080,
"role": "Edit",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Pinewood Camp - Parent Consent Form - Google Chrome
ELEMENT Edit "Plate number" value="" | [
"fill Model: Outback",
"fill Town: Omaha",
"fill Printed: 2026-08-19",
"fill Postcode: 68102",
"fill Manufacturer: Subaru",
"fill Cell: 858.981.2321",
"fill Vehicle ID: J4Q4MBJP3V8G3VVGL",
"fill LinkedIn: linkedin.com/in/hannah-ortega",
"fill Known allergies: Penicillin",
"fill Role: Sales Associa... | 14 | {
"seed": 20080,
"role": "Edit",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Pinewood Camp - Parent Consent Form - Google Chrome
ELEMENT Edit "Drug allergies" value="" | [
"fill Model: Outback",
"fill Town: Omaha",
"fill Printed: 2026-08-19",
"fill Postcode: 68102",
"fill Manufacturer: Subaru",
"fill Cell: 858.981.2321",
"fill Vehicle ID: J4Q4MBJP3V8G3VVGL",
"fill LinkedIn: linkedin.com/in/hannah-ortega",
"fill Known allergies: Penicillin",
"fill Role: Sales Associa... | 8 | {
"seed": 20080,
"role": "Edit",
"action": "fill"
} |
TASK fill the form from the document, then submit
FORM Pinewood Camp - Parent Consent Form - Google Chrome
ELEMENT Edit "VIN" value="" | [
"fill Model: Outback",
"fill Town: Omaha",
"fill Printed: 2026-08-19",
"fill Postcode: 68102",
"fill Manufacturer: Subaru",
"fill Cell: 858.981.2321",
"fill Vehicle ID: J4Q4MBJP3V8G3VVGL",
"fill LinkedIn: linkedin.com/in/hannah-ortega",
"fill Known allergies: Penicillin",
"fill Role: Sales Associa... | 6 | {
"seed": 20080,
"role": "Edit",
"action": "fill"
} |
TASK fill the form from the document, then submit
FORM Pinewood Camp - Parent Consent Form - Google Chrome
ELEMENT Edit "Doctor's name" value="" | [
"fill Model: Outback",
"fill Town: Omaha",
"fill Printed: 2026-08-19",
"fill Postcode: 68102",
"fill Manufacturer: Subaru",
"fill Cell: 858.981.2321",
"fill Vehicle ID: J4Q4MBJP3V8G3VVGL",
"fill LinkedIn: linkedin.com/in/hannah-ortega",
"fill Known allergies: Penicillin",
"fill Role: Sales Associa... | 11 | {
"seed": 20080,
"role": "Edit",
"action": "fill"
} |
TASK fill the form from the document, then submit
FORM Pinewood Camp - Parent Consent Form - Google Chrome
ELEMENT Edit "Zip" value="" hint="ZIP" | [
"fill Model: Outback",
"fill Town: Omaha",
"fill Printed: 2026-08-19",
"fill Postcode: 68102",
"fill Manufacturer: Subaru",
"fill Cell: 858.981.2321",
"fill Vehicle ID: J4Q4MBJP3V8G3VVGL",
"fill LinkedIn: linkedin.com/in/hannah-ortega",
"fill Known allergies: Penicillin",
"fill Role: Sales Associa... | 3 | {
"seed": 20080,
"role": "Edit",
"action": "fill"
} |
TASK fill the form from the document, then submit
FORM Pinewood Camp - Parent Consent Form - Google Chrome
ELEMENT CheckBox "I am legally authorized to work in this country" checked | [
"fill Model: Outback",
"fill Town: Omaha",
"fill Printed: 2026-08-19",
"fill Postcode: 68102",
"fill Manufacturer: Subaru",
"fill Cell: 858.981.2321",
"fill Vehicle ID: J4Q4MBJP3V8G3VVGL",
"fill LinkedIn: linkedin.com/in/hannah-ortega",
"fill Known allergies: Penicillin",
"fill Role: Sales Associa... | 14 | {
"seed": 20080,
"role": "CheckBox",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Pinewood Camp - Parent Consent Form - Google Chrome
ELEMENT Button "Submit application" value="" | [
"fill Model: Outback",
"fill Town: Omaha",
"fill Printed: 2026-08-19",
"fill Postcode: 68102",
"fill Manufacturer: Subaru",
"fill Cell: 858.981.2321",
"fill Vehicle ID: J4Q4MBJP3V8G3VVGL",
"fill LinkedIn: linkedin.com/in/hannah-ortega",
"fill Known allergies: Penicillin",
"fill Role: Sales Associa... | 13 | {
"seed": 20080,
"role": "Button",
"action": "click"
} |
TASK fill the form from the document, then submit
FORM Pinewood Camp - Parent Consent Form - Google Chrome
ELEMENT Button "Reset" value="" | [
"fill Model: Outback",
"fill Town: Omaha",
"fill Printed: 2026-08-19",
"fill Postcode: 68102",
"fill Manufacturer: Subaru",
"fill Cell: 858.981.2321",
"fill Vehicle ID: J4Q4MBJP3V8G3VVGL",
"fill LinkedIn: linkedin.com/in/hannah-ortega",
"fill Known allergies: Penicillin",
"fill Role: Sales Associa... | 14 | {
"seed": 20080,
"role": "Button",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Pinewood Camp - Parent Consent Form - Google Chrome
ELEMENT MenuItem "System" value="" | [
"fill Model: Outback",
"fill Town: Omaha",
"fill Printed: 2026-08-19",
"fill Postcode: 68102",
"fill Manufacturer: Subaru",
"fill Cell: 858.981.2321",
"fill Vehicle ID: J4Q4MBJP3V8G3VVGL",
"fill LinkedIn: linkedin.com/in/hannah-ortega",
"fill Known allergies: Penicillin",
"fill Role: Sales Associa... | 14 | {
"seed": 20080,
"role": "MenuItem",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Pinewood Camp - Parent Consent Form - Google Chrome
ELEMENT Button "Maximize" value="" | [
"fill Model: Outback",
"fill Town: Omaha",
"fill Printed: 2026-08-19",
"fill Postcode: 68102",
"fill Manufacturer: Subaru",
"fill Cell: 858.981.2321",
"fill Vehicle ID: J4Q4MBJP3V8G3VVGL",
"fill LinkedIn: linkedin.com/in/hannah-ortega",
"fill Known allergies: Penicillin",
"fill Role: Sales Associa... | 14 | {
"seed": 20080,
"role": "Button",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Pinewood Camp - Parent Consent Form - Google Chrome
ELEMENT Button "Reload" value="" | [
"fill Model: Outback",
"fill Town: Omaha",
"fill Printed: 2026-08-19",
"fill Postcode: 68102",
"fill Manufacturer: Subaru",
"fill Cell: 858.981.2321",
"fill Vehicle ID: J4Q4MBJP3V8G3VVGL",
"fill LinkedIn: linkedin.com/in/hannah-ortega",
"fill Known allergies: Penicillin",
"fill Role: Sales Associa... | 14 | {
"seed": 20080,
"role": "Button",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Pinewood Camp - Parent Consent Form - Google Chrome
ELEMENT Button "Page down" value="" | [
"fill Model: Outback",
"fill Town: Omaha",
"fill Printed: 2026-08-19",
"fill Postcode: 68102",
"fill Manufacturer: Subaru",
"fill Cell: 858.981.2321",
"fill Vehicle ID: J4Q4MBJP3V8G3VVGL",
"fill LinkedIn: linkedin.com/in/hannah-ortega",
"fill Known allergies: Penicillin",
"fill Role: Sales Associa... | 14 | {
"seed": 20080,
"role": "Button",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Edit "Insurance policy number" value="" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 3 | {
"seed": 27999,
"role": "Edit",
"action": "fill"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Edit "In case of emergency contact" value="" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 18 | {
"seed": 27999,
"role": "Edit",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Edit "Personal website" value="https://andersen.com" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 18 | {
"seed": 27999,
"role": "Edit",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Edit "Insurance company" value="Aetna" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 18 | {
"seed": 27999,
"role": "Edit",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Edit "Date of Birth" value="04/05/1990" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 18 | {
"seed": 27999,
"role": "Edit",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Edit "Referral code (optional)" value="" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 18 | {
"seed": 27999,
"role": "Edit",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Edit "Financial institution" value="Citibank" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 18 | {
"seed": 27999,
"role": "Edit",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Edit "Date of incident" value="" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 1 | {
"seed": 27999,
"role": "Edit",
"action": "fill"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Edit "Routing #" value="753491797" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 18 | {
"seed": 27999,
"role": "Edit",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Edit "Phone number" value="564-288-6081" hint="(555) 555-5555" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 18 | {
"seed": 27999,
"role": "Edit",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Edit "Work phone" value="+1 410 929 9650" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 18 | {
"seed": 27999,
"role": "Edit",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Edit "Home address" value="4824 Maple Blvd" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 18 | {
"seed": 27999,
"role": "Edit",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Edit "Emergency phone" value="" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 7 | {
"seed": 27999,
"role": "Edit",
"action": "fill"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Edit "Group number" value="" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 12 | {
"seed": 27999,
"role": "Edit",
"action": "fill"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Edit "First Name" value="" hint="Given name" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 18 | {
"seed": 27999,
"role": "Edit",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT CheckBox "I agree to the terms and conditions" unchecked | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 16 | {
"seed": 27999,
"role": "CheckBox",
"action": "check"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT CheckBox "I am legally authorized to work in this country" checked | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 18 | {
"seed": 27999,
"role": "CheckBox",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Button "Apply now" value="" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 17 | {
"seed": 27999,
"role": "Button",
"action": "click"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Button "Settings and more" value="" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 18 | {
"seed": 27999,
"role": "Button",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Button "Back" value="" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 18 | {
"seed": 27999,
"role": "Button",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Edit "Address bar" value="jev://orbit-telecom" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 18 | {
"seed": 27999,
"role": "Edit",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Button "Zoom" value="" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 18 | {
"seed": 27999,
"role": "Button",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Button "Page down" value="" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 18 | {
"seed": 27999,
"role": "Button",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Button "Forward" value="" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 18 | {
"seed": 27999,
"role": "Button",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Button "Minimise" value="" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 18 | {
"seed": 27999,
"role": "Button",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Button "Close" value="" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 18 | {
"seed": 27999,
"role": "Button",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM Orbit Telecom - Account Transfer
ELEMENT Edit "Search" value="" | [
"fill Birthday: 04/05/1990",
"fill Date of incident: 12/16/2025",
"fill Work phone: +1 410 929 9650",
"fill Policy number: TGF2837698",
"fill Institution: Citibank",
"fill Reg no: REG6531559",
"fill Office: North campus",
"fill Next of kin tel: (851) 491-1239",
"fill Signature: on file",
"fill Por... | 18 | {
"seed": 27999,
"role": "Edit",
"action": "skip"
} |
TASK fill the form from the document, then submit
FORM JevBrowser
ELEMENT Edit "Promo code (optional)" value="" | [
"fill Family name: Silva",
"fill Country: Australia",
"fill ZIP: 97205",
"fill Blood type: A+",
"fill Registration: 9FX-3000",
"fill Cover letter: Please consider my application for the open position.",
"fill Date of loss: 01/13/2025",
"fill LinkedIn URL: linkedin.com/in/liam-silva",
"fill Forename:... | 17 | {
"seed": 43837,
"role": "Edit",
"action": "skip"
} |
cua-s1-forms (dataset)
Synthetic + real training/eval data for cua-ai/cua-s1-forms,
a jev-like one-pass option scorer for GUI form filling behind
cua-driver.
Generator source: cua_s1/synth.py in
https://github.com/trycua/cua/tree/main/libs/cua-s1.
Files
| file | rows | source |
|---|---|---|
train.jsonl |
~150k | synthetic |
validation.jsonl |
~18k | synthetic |
test.jsonl |
~20k | synthetic, form-signature-disjoint from train/validation |
demo.jsonl |
196 | real: 3 real JevBrowser form pages x 3 real demo PDFs, nothing synthetic |
Format
One JSON object per line:
{"context": "TASK fill the form from the document, then submit\nFORM Northwind Clinic - New Patient Registration\nELEMENT Edit \"Phone number\" value=\"\"",
"options": ["fill Tel: (503) 555-0142", "fill DOB: 03/14/1987", "...", "check", "click", "skip"],
"label": 4,
"meta": {"role": "Edit", "action": "fill"}}
label is the zero-based index into options of the correct choice. options always ends
with the three fixed actions check, click, skip; every option before that is a pointer
to one document entity (fill <entity label>: <entity value>).
How it was built
Each synthetic row comes from a random "episode": a random form (2–16 fields sampled from a
55-concept catalogue, each concept carrying several form-label and document-label synonyms),
a random synthetic person, and a random document built from that person's data plus
distractor entities and forced look-alike confuser pairs (e.g. email vs street address,
phone number vs emergency contact phone, state vs university) so the model has to
read the whole label rather than pattern-match on a keyword. Window titles get random app
suffixes ( - JevBrowser, - Google Chrome, ...) and are dropped entirely 20% of the time.
Splits are disjoint by the exact sorted set of element descriptions in an episode, so a test
form's field set never appears in training.
demo.jsonl is not generated by the sampler: it comes from the three real JevBrowser page
specs and three real demo PDFs (a referral letter, a résumé, a police incident report),
extracted with pdfplumber and hand-mapped to the correct form field, so it measures actual
transfer rather than in-distribution synthetic accuracy.
License
MIT. The underlying synthetic values (names, addresses, etc.) are procedurally generated, not drawn from any real individual's data.
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