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