0000879635-24-000079.txt : 20240403 0000879635-24-000079.hdr.sgml : 20240403 20240403143329 ACCESSION NUMBER: 0000879635-24-000079 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240401 FILED AS OF DATE: 20240403 DATE AS OF CHANGE: 20240403 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Evans Albert J. CENTRAL INDEX KEY: 0001749416 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 24818144 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] ORGANIZATION NAME: 02 Finance 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_1712169196.xml FORM 4 X0508 4 2024-04-01 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 Restricted Stock 2024-04-01 4 A 0 999 0 A 999 D Mid Penn Bancorp, Inc. Common Stock 25385.05 D Mid Penn Bancorp, Inc. Common Stock 1208 I Company-owned Shares granted in the form of restricted stock, which vests 100% on the first anniversary of the date of grant. Balance includes shares acquired through the Dividend Reinvestment Plan. Shares held in the name of Frontier Trust FSB, TTEE Fanelli, Evans & Patel. /s/ Albert J. Evans 2024-04-03