0000879635-24-000099.txt : 20240403 0000879635-24-000099.hdr.sgml : 20240403 20240403150155 ACCESSION NUMBER: 0000879635-24-000099 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: Micklewright Scott W CENTRAL INDEX KEY: 0001494991 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 24818276 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_1712170904.xml FORM 4 X0508 4 2024-04-01 0 0000879635 MID PENN BANCORP INC MPB 0001494991 Micklewright Scott W 2407 PARK DRIVE HARRISBURG PA 17110 0 1 0 0 Chief Revenue Officer 0 Mid Penn Bancorp, Inc. Common Restricted Stock 2024-04-01 4 A 0 1997 0 A 4461 D Mid Penn Bancorp, Inc. Common Stock 14834.014 D Shares granted in the form of restricted stock which vest ratably over four years. Shares granted in the form of restricted stock, which vest according to the terms of each respective grant. Balance includes shares acquired through Employee Stock Purchase Plan and Dividend Reinvestment Plan and shares of restricted stock that vested on 4/01/2024. /s/ Scott W. Micklewright 2024-04-03