0001171843-22-001490.txt : 20220301 0001171843-22-001490.hdr.sgml : 20220301 20220301141017 ACCESSION NUMBER: 0001171843-22-001490 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220225 FILED AS OF DATE: 20220301 DATE AS OF CHANGE: 20220301 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MOWERY THEODORE W CENTRAL INDEX KEY: 0001278504 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 22696711 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: 2407 PARK DRIVE CITY: HARRISBURG STATE: PA ZIP: 17110 BUSINESS PHONE: 8666427736 MAIL ADDRESS: STREET 1: 2407 PARK DRIVE CITY: HARRISBURG STATE: PA ZIP: 17110 4 1 ownership.xml X0306 4 2022-02-25 0 0000879635 MID PENN BANCORP INC MPB 0001278504 MOWERY THEODORE W 2407 PARK DR. HARRISBURG PA 17110 1 0 0 0 Mid Penn Bancorp, Inc. Common Stock 2022-02-25 4 P 0 150 28.8682 A 19023.218 D Mid Penn Bancorp, Inc. Common Stock 2022-02-25 4 P 0 50 29.0899 A 7823.924 I IRA Mid Penn Bancorp, Inc. Common Stock 703 D 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/ Theodore W. Mowery 2022-03-01