0001171843-20-001619.txt : 20200310 0001171843-20-001619.hdr.sgml : 20200310 20200310170302 ACCESSION NUMBER: 0001171843-20-001619 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200310 FILED AS OF DATE: 20200310 DATE AS OF CHANGE: 20200310 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: RITRIEVI RORY G CENTRAL INDEX KEY: 0001230831 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 20702652 MAIL ADDRESS: STREET 1: 1019 TUNBRIDGE LANE CITY: MECHANICSBURG STATE: PA ZIP: 17050 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 STREET CITY: MILLERSBURG STATE: PA ZIP: 17061 BUSINESS PHONE: 8666427736 MAIL ADDRESS: STREET 1: 349 UNION STREET CITY: MILLERSBURG STATE: PA ZIP: 17061 4 1 ownership.xml X0306 4 2020-03-10 0 0000879635 MID PENN BANCORP INC MPB 0001230831 RITRIEVI RORY G 1019 TUNBRIDGE LANE MECHANICSBURG PA 17050 1 1 0 0 President and CEO Mid Penn Bancorp, Inc. Common Stock 2020-03-10 4 P 0 100 17.8423 A 16811.6787 D Mid Penn Bancorp, Inc. Common Stock 6625 D Mid Penn Bancorp, Inc. Common Stock 3739.5825 I IRA Balance includes shares acquired through Employee Stock Purchase Plan and Dividend Reinvestment Plan. Shares granted in the form of restricted stock, which vests, subject to acceleration upon certain occurrences, 25% on each anniversary of the date of grant (each, a "vesting tranche"), but only if such reporting person remains continuously employed through the applicable anniversary date. Balance includes shares acquired through Dividend Reinvestment Plan. /s/ Rory G. Ritrievi 2020-03-10