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Invoices and forms

Insurance claim checkbox correction 2

Original source · Answer-key source

CC0-1.0. Made-up fixture generated for The Hype Kevin; dedicated to CC0. No real entities or personal data.

Insurance claim checkbox correction 2

The answer key

Check numbers below match the grid columns. An absence check requires the stated value to be absent in its stated field.

Retained checks
CheckKindExpected answerField / row / column
1textCL-FABLE-411
2textFictional Moss Comet Studio
3blankPurchase order (required)

Model-by-check results

Right and Wrong describe exact checks. No output scores zero. Tab reaches each result.

Every model, every retained check
ModelPage checks rightPage score / 100123
Claude Opus 5.53/3100.0RightRightRight
GPT-6.1 Sol3/3100.0RightRightRight
Claude Sonnet 5.53/3100.0RightRightRight
Gemini 3.8 Flash3/3100.0RightRightRight
Gemini 4 Argon3/3100.0RightRightRight
Chandra OCR 2 4-bit3/3100.0RightRightRight
Mistral OCR3/3100.0RightRightRight
GPT-6 Luna3/3100.0RightRightRight
LightOnOCR 3 1B2/366.7RightRightWrong
OCRia-10/30.0WrongWrongWrong
dots.ocr 4-bit3/3100.0RightRightRight
Nemotron 3.5 Parse3/3100.0RightRightRight
Indra3/3100.0RightRightRight
Granite-Docling3/3100.0RightRightRight
PaddleOCR-VL 1.63/3100.0RightRightRight
Tesseract 5.5.33/3100.0RightRightRight

Raw model outputs beside the key

Key reference

  1. CL-FABLE-411
  2. Fictional Moss Comet Studio
Claude Opus 5.5 · 3/3 checks in scoring unit

Scoring unit: checkbox-form-2. Joined pages use the same full output.

FICTIONAL SAMPLE • All entities and addresses are invented • CC0

# Fictional Umbrella Pebble Insurance

## Claim CL-FABLE-411

Claimant: Fictional Moss Comet Studio
Date: 2026-10-22

Purchase order (required): blank

---

Other cover: N/A

---

Loss amount USD: 2,608.45

---

Delivery: ☑ Standard ~~☑~~ ☒ Express (ticked box crossed out — cancelled)

---

*Crossed box cancelled; new tick applies. QZ*

Contact: ☑ Email ☐ Phone

---

Inspection: ☑ Yes ☐ No

---

checkbox-form-2 · checkbox-form-2 · page 1
GPT-6.1 Sol · 3/3 checks in scoring unit

Scoring unit: checkbox-form-2. Joined pages use the same full output.

FICTIONAL SAMPLE • All entities and addresses are invented • CC0

# Fictional Umbrella Pebble Insurance

## Claim CL-FABLE-411

Claimant: Fictional Moss Comet Studio  
Date: 2026-10-22

Purchase order (required): blank

---

Other cover: N/A

---

Loss amount USD: 2,608.45

---

Delivery: ☑ Standard ~~☑~~ Express

---

Crossed box cancelled; new tick applies. QZ

Contact: ☑ Email ☐ Phone

---

Inspection: ☑ Yes ☐ No

---

checkbox-form-2 · checkbox-form-2 · page 1
Claude Sonnet 5.5 · 3/3 checks in scoring unit

Scoring unit: checkbox-form-2. Joined pages use the same full output.

FICTIONAL SAMPLE • All entities and addresses are invented • CC0

# Fictional Umbrella Pebble Insurance

## Claim CL-FABLE-411

Claimant: Fictional Moss Comet Studio
Date: 2026-10-22

Purchase order (required): blank

---

Other cover: N/A

---

Loss amount USD: 2,608.45

---

Delivery: ☑ Standard ~~☒ Express~~

---

*Crossed box cancelled; new tick applies. QZ*

Contact: ☑ Email ☐ Phone

---

Inspection: ☑ Yes ☐ No

---

checkbox-form-2 · checkbox-form-2 · page 1
Gemini 3.8 Flash · 3/3 checks in scoring unit

Scoring unit: checkbox-form-2. Joined pages use the same full output.

FICTIONAL SAMPLE • All entities and addresses are invented • CC0

# Fictional Umbrella Pebble Insurance

### Claim CL-FABLE-411

Claimant: Fictional Moss Comet Studio  
Date: 2026-10-22

Purchase order (required): blank

---

Other cover: N/A

---

Loss amount USD: 2,608.45

---

Delivery: [x] Standard [~~x~~] Express

---

Crossed box cancelled; new tick applies. QZ

Contact: [x] Email [ ] Phone

---

Inspection: [x] Yes [ ] No

---

checkbox-form-2 · checkbox-form-2 · page 1
Gemini 4 Argon · 3/3 checks in scoring unit

Scoring unit: checkbox-form-2. Joined pages use the same full output.

FICTIONAL SAMPLE • All entities and addresses are invented • CC0

# Fictional Umbrella Pebble Insurance

## Claim CL-FABLE-411

Claimant: Fictional Moss Comet Studio
Date: 2026-10-22

Purchase order (required): blank

---

Other cover: N/A

---

Loss amount USD: 2,608.45

---

Delivery: [x] Standard ~~[x] Express~~

---

Crossed box cancelled; new tick applies. QZ

Contact: [x] Email [ ] Phone

---

Inspection: [x] Yes [ ] No

---

checkbox-form-2 · checkbox-form-2 · page 1
Chandra OCR 2 · 3/3 checks in scoring unit

Scoring unit: checkbox-form-2. Joined pages use the same full output.

<div data-bbox="53 38 454 52" data-label="Page-Header"><p>FICTIONAL SAMPLE • All entities and addresses are invented • CC0</p></div><div data-bbox="53 63 705 93" data-label="Section-Header"><h1>Fictional Umbrella Pebble Insurance</h1></div><div data-bbox="53 108 314 130" data-label="Section-Header"><h2>Claim CL-FABLE-411</h2></div><div data-bbox="53 145 395 162" data-label="Text"><p>Claimant: Fictional Moss Comet Studio</p></div><div data-bbox="53 166 211 183" data-label="Text"><p>Date: 2026-10-22</p></div><div data-bbox="53 211 508 230" data-label="Text"><p>Purchase order (required): _____</p></div><div data-bbox="53 257 204 274" data-label="Text"><p>Other cover: N/A</p></div><div data-bbox="53 303 304 321" data-label="Text"><p>Loss amount USD: 2,608.45</p></div><div data-bbox="53 350 373 372" data-label="Text"><p>Delivery: <input checked="" type="checkbox"/> Standard <input checked="" type="checkbox"/> Express</p></div><div data-bbox="53 400 548 424" data-label="Text"><p><i>Crossed box cancelled; new tick applies. @Z</i></p></div><div data-bbox="53 452 326 473" data-label="Text"><p>Contact: <input checked="" type="checkbox"/> Email <input type="checkbox"/> Phone</p></div><div data-bbox="53 503 298 523" data-label="Text"><p>Inspection: <input checked="" type="checkbox"/> Yes <input type="checkbox"/> No</p></div><div data-bbox="53 960 314 975" data-label="Page-Footer"><p>checkbox-form-2 · checkbox-form-2 · page 1</p></div>
Mistral OCR · 3/3 checks in scoring unit

Scoring unit: checkbox-form-2. Joined pages use the same full output.

<file name="checkbox-form-2.pdf">
FICTIONAL SAMPLE • All entities and addresses are invented • CC0

# Fictional Umbrella Pebble Insurance

## Claim CL-FABLE-411

Claimant: Fictional Moss Comet Studio
Date: 2026-10-22

Purchase order (required): _________________________

Other cover: N/A

Loss amount USD: 2,608.45

Delivery: ☑ Standard ☒ Express

*Crossed box cancelled; new tick applies. QZ*

Contact: ☑ Email ☐ Phone

Inspection: ☑ Yes ☐ No

checkbox-form-2 · checkbox-form-2 · page 1
</file>
GPT-6 Luna · 3/3 checks in scoring unit

Scoring unit: checkbox-form-2. Joined pages use the same full output.

FICTIONAL SAMPLE • All entities and addresses are invented • CC0

# Fictional Umbrella Pebble Insurance

## Claim CL-FABLE-411

Claimant: Fictional Moss Comet Studio  
Date: 2026-10-22

Purchase order (required): blank

Other cover: N/A

Loss amount USD: 2,608.45

Delivery: [✓] Standard [crossed-out box] Express

Crossed box cancelled; new tick applies. QZ

Contact: [✓] Email [ ] Phone

Inspection: [✓] Yes [ ] No

checkbox-form-2 · checkbox-form-2 · page 1
LightOnOCR 3 1B · 2/3 checks in scoring unit

Scoring unit: checkbox-form-2. Joined pages use the same full output.

![header](63,35,482,48) FICTIONAL SAMPLE • All entities and addresses are invented • CC0

![title](62,59,717,92) # Fictional Umbrella Pebble Insurance

![title](68,105,357,128) ## Claim CL-FABLE-411

![text](68,144,428,181) Claimant: Fictional Moss Comet Studio Date: 2026-10-22

![text](68,211,325,229) Purchase order (required): _________________________

![text](68,259,221,277) Other cover: N/A

![text](68,306,345,324) Loss amount USD: 2,608.45

![text](68,355,404,377) Delivery: ☑ Standard  ✗ Express

![text](68,405,569,429) *Crossed box cancelled; new tick applies. QZ*

![text](68,460,378,480) Contact: ☑ Email  □ Phone

![text](68,512,340,533) Inspection: ☑ Yes  □ No

![footer](68,959,349,972) checkbox-form-2 · checkbox-form-2 · page 1

OCRia-1 · 0/3 checks in scoring unit

Scoring unit: checkbox-form-2. Joined pages use the same full output.

checkbox-form-2 · checkbox-form-2 · page 1
dots.ocr · 3/3 checks in scoring unit

Scoring unit: checkbox-form-2. Joined pages use the same full output.

FICTIONAL SAMPLE • All entities and addresses are invented • CC0

# Fictional Umbrella Pebble Insurance

Claim CL-FABLE-411

Claimant: Fictional Moss Comet Studio
Date: 2026-10-22

Purchase order (required): _________________

Other cover: N/A

Loss amount USD: 2,608.45

Delivery: ☑ Standard ☑ Express

Crossed box cancelled; new tick applies. QZ

Contact: ☑ Email ☐ Phone

Inspection: ☑ Yes ☐ No
Nemotron 3.5 Parse · 3/3 checks in scoring unit

Scoring unit: checkbox-form-2. Joined pages use the same full output.

FICTIONAL SAMPLE • All entities and addresses are invented • CC0

# **Fictional Umbrella Pebble Insurance**

## **Claim CL-FABLE-411**

Claimant: Fictional Moss Comet Studio
Date: 2026-10-22

Purchase order (required): __________________

Other cover: N/A

Loss amount USD: 2,608.45

Delivery:

☑ Standard

☒

Express

Crossed box cancelled; new tick applies. QZ

Contact:

☑ Email

☐ Phone

Inspection:

☑ Yes

☐ No

checkbox-form-2 · checkbox-form-2 · page 1
Indra · 3/3 checks in scoring unit

Scoring unit: checkbox-form-2. Joined pages use the same full output.

## Fictional Umbrella Pebble Insurance

Claim CL-FABLE-411

Claimant: Fictional Moss Comet Studio

Date: 2026-10-22

Purchase order (required):

Other cover: N/A

Loss amount USD: 2,608.45

Delivery: [V] Standard ] Express

Crossed box cancelled; new tick applies. 2Z

Contact: [] Email ] Phone

Inspection: [] Yes No
Granite-Docling · 3/3 checks in scoring unit

Scoring unit: checkbox-form-2. Joined pages use the same full output.

## Fictional Umbrella Pebble Insurance

## Claim CL-FABLE-411

Claimant: Fictional Moss Comet Studio

Date: 2026-10-22

Purchase order (required): \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Other cover: N/A

Loss amount USD: 2,608.45

Delivery:

Standard

Express

Crossed box cancelled; new tick applies. Qz

Contact:

Email

Phone

Inspection:

Yes

No
PaddleOCR-VL 1.6 · 3/3 checks in scoring unit

Scoring unit: checkbox-form-2. Joined pages use the same full output.

FICTIONAL SAMPLE • All entities and addresses are invented • CC0
Fictional Umbrella Pebble Insurance
Claim CL-FABLE-411
Claimant: Fictional Moss Comet Studio
Date: 2026-10-22
Purchase order (required): _____
Other cover: N/A
Loss amount USD: 2,608.45
Delivery: ☑ Standard ☒ Express
Crossed box cancelled; new tick applies. QZ
Contact: ☑ Email ☐ Phone
Inspection: ☑ Yes ☐ No
checkbox-form-2 · checkbox-form-2 · page 1
Tesseract 5.5.3 · 3/3 checks in scoring unit

Scoring unit: checkbox-form-2. Joined pages use the same full output.

FICTIONAL SAMPLE * All entities and addresses are invented + CCO

Fictional Umbrella Pebble Insurance
Claim CL-FABLE-411

Claimant: Fictional Moss Comet Studio
Date: 2026-10-22

Purchase order (required):
Other cover: N/A

Loss amount USD: 2,608.45

Delivery: Standard x Express

Crossed box cancelled; new tick applies. QZ,
Contact: Email [_] Phone

Inspection: [Y] Yes [_] No

checkbox-form-2 - checkbox-form-2 - page 1