0001171843-21-003031.txt : 20210503
0001171843-21-003031.hdr.sgml : 20210503
20210503155715
ACCESSION NUMBER: 0001171843-21-003031
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210430
FILED AS OF DATE: 20210503
DATE AS OF CHANGE: 20210503
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Webb Justin T.
CENTRAL INDEX KEY: 0001555503
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-13677
FILM NUMBER: 21883416
MAIL ADDRESS:
STREET 1: 147 BURROUGHS DRIVE
CITY: AMHERST
STATE: NY
ZIP: 14226
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
4
1
ownership.xml
X0306
4
2021-04-30
0
0000879635
MID PENN BANCORP INC
MPB
0001555503
Webb Justin T.
734 LINDEN ROAD
HERSHEY
PA
17033
0
1
0
0
SEVP and COO
Mid Penn Bancorp, Inc. Common Stock
2021-04-30
4
P
0
1000
25.00
A
5104.879
D
Mid Penn Bancorp, Inc. Common Stock
3750
I
IRA
Mid Penn Bancorp, Inc. Common Stock
2812
D
Balance includes shares acquired through the Employee Stock Purchase Plan and Dividend Reinvestment Plan.
Shares granted in the form of Restricted Stock which vests according to the terms of each respective grant.
/s/ Justin T. Webb
2021-05-03