0001171843-21-006779.txt : 20211001
0001171843-21-006779.hdr.sgml : 20211001
20211001150903
ACCESSION NUMBER: 0001171843-21-006779
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: Moisey Robert J
CENTRAL INDEX KEY: 0001634924
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-13677
FILM NUMBER: 211298547
MAIL ADDRESS:
STREET 1: 349 UNION STREET
CITY: MILLERSBURG
STATE: PA
ZIP: 17061
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
0001634924
Moisey Robert J
563 WEST FOOTHILLS DRIVE
SUGARLOAF
PA
18249
1
0
0
0
Mid Penn Bancorp, Inc. Common Stock
2021-09-30
4
P
0
109
27.55
A
22042.824
D
Mid Penn Bancorp, Inc. Common Stock
440
D
Mid Penn Bancorp, Inc. Common Stock
550
I
IRA
Mid Penn Bancorp, Inc. Common Stock
8713.456
I
By Spouse
Mid Penn Bancorp, Inc. Common Stock
4000
I
By Spouse for PUTMA
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 J. Moisey
2021-10-01