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