0001171843-21-006778.txt : 20211001 0001171843-21-006778.hdr.sgml : 20211001 20211001150433 ACCESSION NUMBER: 0001171843-21-006778 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210930 FILED AS OF DATE: 20211001 DATE AS OF CHANGE: 20211001 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Grubic Robert C CENTRAL INDEX KEY: 0001348171 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 211298514 MAIL ADDRESS: STREET 1: 4315 STONELEIGH COURT CITY: HARRISBURG STATE: PA ZIP: 17112 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 2021-09-30 0 0000879635 MID PENN BANCORP INC MPB 0001348171 Grubic Robert C 4315 STONELEIGH COURT HARRISBURG PA 17112 1 0 0 0 Mid Penn Bancorp, Inc. Common Stock 2021-09-30 4 P 0 181 27.55 A 53239.231 D Mid Penn Bancorp, Inc. Common Stock 703 D Shares purchased through the Director Stock Purchase Plan. Balance includes shares acquired through the Dividend Reinvestment Plan. Shares granted in the form of restricted stock, which vests 100% on the first anniversary of the date of grant. /s/ Robert C. Grubic 2021-10-01