0001171843-17-002495.txt : 20170502 0001171843-17-002495.hdr.sgml : 20170502 20170502123016 ACCESSION NUMBER: 0001171843-17-002495 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170501 FILED AS OF DATE: 20170502 DATE AS OF CHANGE: 20170502 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 STREET CITY: MILLERSBURG STATE: PA ZIP: 17061 BUSINESS PHONE: 8666427736 MAIL ADDRESS: STREET 1: 349 UNION STREET CITY: MILLERSBURG STATE: PA ZIP: 17061 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Neiderer Kelly K CENTRAL INDEX KEY: 0001571102 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 17803900 MAIL ADDRESS: STREET 1: 281 N. OLD STONEHOUSE RD. CITY: CARLISLE STATE: PA ZIP: 17015 4 1 formfour.xml OWNERSHIP DOCUMENT X0306 4 2017-05-01 0 0000879635 MID PENN BANCORP INC MPB 0001571102 Neiderer Kelly K 281 N. OLD STONEHOUSE RD. CARLISLE PA 17015 0 1 0 0 EVP and Chief Retail Officer Mid Penn Bancorp, Inc. Common Stock 2017-05-01 4 P 0 1000 27.508 A 4694.5056 D Balance includes shares acquired through Employee Stock Purchase Plan and Dividend Reinvestment Plan, and shares granted in the form of restricted stock. /s/ Kelly K. Neiderer 2017-05-02