0001171843-15-000488.txt : 20150130
0001171843-15-000488.hdr.sgml : 20150130
20150130162141
ACCESSION NUMBER: 0001171843-15-000488
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150130
FILED AS OF DATE: 20150130
DATE AS OF CHANGE: 20150130
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 ST
CITY: MILLERSBURG
STATE: PA
ZIP: 17061
BUSINESS PHONE: 7176922133
MAIL ADDRESS:
STREET 1: 349 UNION STREET
STREET 2: 349 UNION STREET
CITY: MILLERSBURG
STATE: PA
ZIP: 17061
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: 15563341
MAIL ADDRESS:
STREET 1: 1019 TUNBRIDGE LANE
CITY: MECHANICSBURG
STATE: PA
ZIP: 17050
4
1
form4.xml
OWNERSHIP DOCUMENT
X0306
4
2015-01-30
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
2015-01-30
4
P
0
20
15.739
A
3233.8895
I
IRA
Mid Penn Bancorp, Inc. Common Stock
2015-01-30
4
P
0
1000
15.4906
A
5503.395
D
Mid Penn Bancorp, Inc. Common Stock
2186.6141
D
Balance includes shares acquired through Dividend Reinvestment Plan.
Balance includes shares acquired through Employee Stock Purchase Plan and Dividend Reinvestment Plan.
/s/ Rory G. Ritrievi
2015-01-30