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