Bankers Express Mortgage, Inc. Loan Application

ATTENTION!!

Our mission at Bankers Express Mortgage is to provide you with the best and fastest service.

Because of the overwhelming amount of Internet applications we receive each day from across the country, it is sometimes hard to contact everyone that fills out our Internet application in a timely manner. So, we highly encourage you to call our customer rep directly and we will provide you with the swift personal service you deserve, as well as automatically giving you a $200 discount on your loan.

Call toll free (888)845-8888 now and ask for the "Internet Customer Service Dept."

If you still want to fill in the application over the Internet, start below.

You are now behind our secure server. Please take a few moments to fully complete the following on-line application. As soon as we receive it, we will give you a call to discuss your loan.

If you are already familiar with our products and would like more information, please call 1-888-845-8888

Borrower Information:

Name:

E-Mail Address:

Address:

City: .State: .Zip:

Social Security Number:

Home Telephone:

Self Employed:

Business Telephone:

Annual Income:

Co. Borrower Information:

Name:

Address: If same, click here:

City: .State: .Zip:

Social Security Number:

Home Telephone Number: If same, click here:

Self Employed:

Business Telephone Number:

Annual Income:

Loan Request:

Purchase: Refinance:

Property Information:

Owner Occupied:

Value of Property:

Type of Property:

Interest Rate: ...Term:

Current Mortgage Lender:

Balance: ...Payment:

Do you have a second mortgage:

For our Information:

How did you find out about us:

If you selected 'other,' please elaborate: