-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, GrFygqw2l4TyikBXSn9+y7hZ5ObD1STP6KSI4IHWAa9EWrVlzBIaAkrYlbzGS39h sUCF8VNHN02pCEn5p+tGkg== 0000930413-04-005067.txt : 20041103 0000930413-04-005067.hdr.sgml : 20041103 20041103171227 ACCESSION NUMBER: 0000930413-04-005067 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041102 FILED AS OF DATE: 20041103 DATE AS OF CHANGE: 20041103 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DURICA A JAMES CENTRAL INDEX KEY: 0001272238 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 041117088 BUSINESS ADDRESS: STREET 1: 453 LAUREL DRIVE CITY: HERSHEY STATE: PA ZIP: 17033 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: 349 UNION ST CITY: MILLERSBURG STATE: PA ZIP: 17061 BUSINESS PHONE: 7176922133 MAIL ADDRESS: STREET 1: 349 UNION STREET STREET 2: 349 UNION STREET CITY: MILLERSBURG STATE: PA ZIP: 17061 4 1 c34302_ex.xml X0202 4 2004-11-02 0 0000879635 MID PENN BANCORP INC MBP 0001272238 DURICA A JAMES 453 LAUREL DRIVE HERSHEY PA 17033 1 0 0 0 Common Stock 2004-11-02 4 P 0 500 26.55 D 500 D /s/ A. James Durica 2004-11-03 -----END PRIVACY-ENHANCED MESSAGE-----