0001171843-22-005523.txt : 20220809 0001171843-22-005523.hdr.sgml : 20220809 20220809132102 ACCESSION NUMBER: 0001171843-22-005523 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220804 FILED AS OF DATE: 20220809 DATE AS OF CHANGE: 20220809 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: 221147430 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 2022-08-04 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 2022-08-04 4 P 0 5000 28.9472 A 12939.438 I IRA Mid Penn Bancorp, Inc. Common Stock 21156.739 D Mid Penn Bancorp, Inc. Common Stock 1133 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 2022-08-09