0000879635-23-000100.txt : 20231106 0000879635-23-000100.hdr.sgml : 20231106 20231106120612 ACCESSION NUMBER: 0000879635-23-000100 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231102 FILED AS OF DATE: 20231106 DATE AS OF CHANGE: 20231106 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Evans Albert J. CENTRAL INDEX KEY: 0001749416 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 231379107 MAIL ADDRESS: STREET 1: 2407 PARK DRIVE CITY: HARRISBURG STATE: PA ZIP: 17110 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: 2407 PARK DRIVE CITY: HARRISBURG STATE: PA ZIP: 17110 BUSINESS PHONE: 8666427736 MAIL ADDRESS: STREET 1: 2407 PARK DRIVE CITY: HARRISBURG STATE: PA ZIP: 17110 4 1 wk-form4_1699290364.xml FORM 4 X0508 4 2023-11-02 0 0000879635 MID PENN BANCORP INC MPB 0001749416 Evans Albert J. 2407 PARK DRIVE HARRISBURG PA 17110 1 0 0 0 0 Mid Penn Bancorp, Inc. Common Stock 2023-11-02 4 P 0 3800 19.607 A 24404 D Mid Penn Bancorp, Inc. Common Stock 1208 I Company-owned Shares held in the name of Frontier Trust FSB, TTEE Fanelli, Evans & Patel. A Form 3 with respect to the Corporation was filed by Albert Evans on 12/01/2021. He subsequently filed Forms 4 until it was determined that he was relieved of his Section 16 filing obligations. As of May 19, 2023, Mr. Evans again became subject to Section 16 reporting with respect to the Corporation and is filing this Form 4 in light therof. /s/ Albert J. Evans 2023-11-06