0001171843-23-002121.txt : 20230404 0001171843-23-002121.hdr.sgml : 20230404 20230404140920 ACCESSION NUMBER: 0001171843-23-002121 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230401 FILED AS OF DATE: 20230404 DATE AS OF CHANGE: 20230404 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Webb Justin T. CENTRAL INDEX KEY: 0001555503 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 23796470 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 X0407 4 2023-04-01 0 0000879635 MID PENN BANCORP INC MPB 0001555503 Webb Justin T. 2407 PARK DRIVE HARRISBURG PA 17110 0 1 0 0 SEVP and COO 0 Mid Penn Bancorp, Inc. Common Stock 2023-04-01 4 A 0 1562 0 A 3783 D Mid Penn Bancorp, Inc. Common Stock 8721.769 D Mid Penn Bancorp, Inc. Common Stock 3750 I IRA Shares granted in the form of restricted stock which vest ratably over four years. Shares granted in the form of restricted stock which vest according to the terms of each respective grant. Balance includes shares acquired through Employee Stock Purchase Plan and Dividend Reinvestment Plan and shares of restricted stock that vested on 4/01/2023. /s/ Justin T. Webb 2023-04-04