0001171843-22-002367.txt : 20220405 0001171843-22-002367.hdr.sgml : 20220405 20220405111329 ACCESSION NUMBER: 0001171843-22-002367 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220401 FILED AS OF DATE: 20220405 DATE AS OF CHANGE: 20220405 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: 22805628 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 2022-04-01 0 0000879635 MID PENN BANCORP INC MPB 0001348171 Grubic Robert C 2407 PARK DR. HARRISBURG PA 17110 1 0 0 0 Mid Penn Bancorp, Inc. Common Stock 2022-04-01 4 A 0 1133 0 A 1836 D Mid Penn Bancorp, Inc. Common Stock 54681.660 D Shares granted in the form of restricted stock which vests according to the terms of each respective grant. Balance includes shares acquired through Dividend Reinvestment Plan. /s/ Robert C. Grubic 2022-04-05