0001171843-23-002122.txt : 20230404 0001171843-23-002122.hdr.sgml : 20230404 20230404145144 ACCESSION NUMBER: 0001171843-23-002122 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: Johnson Allison CENTRAL INDEX KEY: 0001812002 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 23796730 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 0001812002 Johnson Allison 2407 PARK DRIVE HARRISBURG PA 17110 0 1 0 0 SEVP and CFO 0 Mid Penn Bancorp, Inc. Common Stock 2023-04-01 4 A 0 1562 0 A 5562 D 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. /s/ Allison S. Johnson 2023-04-04