0001171843-15-001553.txt : 20150320 0001171843-15-001553.hdr.sgml : 20150320 20150320163938 ACCESSION NUMBER: 0001171843-15-001553 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150320 FILED AS OF DATE: 20150320 DATE AS OF CHANGE: 20150320 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MID PENN BANCORP INC CENTRAL INDEX KEY: 0000879635 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 251666413 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 349 UNION ST CITY: MILLERSBURG STATE: PA ZIP: 17061 BUSINESS PHONE: 7176922133 MAIL ADDRESS: STREET 1: 349 UNION STREET STREET 2: 349 UNION STREET CITY: MILLERSBURG STATE: PA ZIP: 17061 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Webb Justin T. CENTRAL INDEX KEY: 0001555503 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 15716696 MAIL ADDRESS: STREET 1: 147 BURROUGHS DRIVE CITY: AMHERST STATE: NY ZIP: 14226 4 1 form4webb.xml OWNERSHIP DOCUMENT X0306 4 2015-03-20 0 0000879635 MID PENN BANCORP INC MPB 0001555503 Webb Justin T. 321 HIGHLAND ROAD HERSHEY PA 17033 0 1 0 0 EVP and Chief Risk Officer Mid Penn Bancorp, Inc. Common Stock 438.827 D Mid Penn Bancorp, Inc. Common Stock 2015-03-20 4 P 0 96 15.85 A 596 I IRA Mid Penn Bancorp, Inc. Common Stock 2015-03-20 4 P 0 154 15.8358 A 750 I IRA Balance includes shares acquired through Employee Stock Purchase Plan and Dividend Reinvestment Plan. /s/ Justin T. Webb 2015-03-20