0001171843-21-008535.txt : 20211215
0001171843-21-008535.hdr.sgml : 20211215
20211215161815
ACCESSION NUMBER: 0001171843-21-008535
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211214
FILED AS OF DATE: 20211215
DATE AS OF CHANGE: 20211215
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SPARKS DAVID E
CENTRAL INDEX KEY: 0001285758
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-13677
FILM NUMBER: 211494406
MAIL ADDRESS:
STREET 1: 2407 PARK DRIVE
CITY: HARRISBURG
STATE: PA
ZIP: 17110
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
2021-12-14
0
0000879635
MID PENN BANCORP INC
MPB
0001285758
SPARKS DAVID E
2407 PARK DRIVE
HARRISBURG
PA
17110
1
0
0
0
Mid Penn Bancorp, Inc. Common Stock
2021-12-14
4
S
0
500
29.86
D
5562
I
By Sparks Family Foundation
Mid Penn Bancorp, Inc. Common Stock
69342
D
Mid Penn Bancorp, Inc. Common Stock
10572
I
IRA
Mid Penn Bancorp, Inc. Common Stock
25901
I
By Spouse
Mid Penn Bancorp, Inc. Common Stock
703
D
Shares granted in the form of restricted stock which vests according to the terms of each respective grant.
/s/ David E. Sparks
2021-12-15