0001171843-22-004069.txt : 20220601 0001171843-22-004069.hdr.sgml : 20220601 20220601123530 ACCESSION NUMBER: 0001171843-22-004069 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220601 FILED AS OF DATE: 20220601 DATE AS OF CHANGE: 20220601 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Johnson Allison CENTRAL INDEX KEY: 0001812002 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 22986672 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 2022-06-01 0 0000879635 MID PENN BANCORP INC MPB 0001812002 Johnson Allison 2407 PARK DRIVE HARRISBURG PA 17110 0 1 0 0 SEVP and CFO Mid Penn Bancorp, Inc. Common Stock 2022-06-01 4 A 0 4000 0 A 4000 D Shares granted in the form of restricted stock, which vests, subject to acceleration upon certain occurrences, 25% on each anniversary date of grant (each, a "vesting tranche"), but only if such reporting person remains continuously employed through the applicable anniversary date. /s/ Allison S. Johnson 2022-06-01