-----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, P7rcbMHHdM0KLuGd9yADonylAW3MMFxBwCpimfT5qqWp7zpb4DJO8vrh0JrtVvC4 faK3KUL1bunzHB1bYnlddA== 0001005150-03-001428.txt : 20030829 0001005150-03-001428.hdr.sgml : 20030829 20030829165651 ACCESSION NUMBER: 0001005150-03-001428 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030828 FILED AS OF DATE: 20030829 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SHAFFER EUGENE F CENTRAL INDEX KEY: 0001253418 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 03874662 BUSINESS ADDRESS: STREET 1: 903 EAST UNION ST CITY: MILLERSBURG STATE: PA ZIP: 17061 BUSINESS PHONE: 7176922133 4 1 primary_doc.xml PRIMARY DOCUMENT X0201 4 2003-08-28 0 0000879635 MID PENN BANCORP INC MBP 0001253418 SHAFFER EUGENE F 903 EAST UNION STREET MILLERSBURG PA 17061 1 1 0 0 Chairman of Issuer and Sub Common Stock 2003-08-28 4 S 0 500 23.5 D 36943 I By Trust Common Stock 82642 D Excludes fractional share amounts. Eugene Shaffer 2003-08-29 -----END PRIVACY-ENHANCED MESSAGE-----