-----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, AIBaAOHR8JiZdzquV/1xDvfYCmnA8lIR5nYTD84xVfiFwY9mmAYvjlxBWk0jGxDp evFuaHkAp/rvT2N/TH39hg== 0001005150-04-000177.txt : 20040204 0001005150-04-000177.hdr.sgml : 20040204 20040204132904 ACCESSION NUMBER: 0001005150-04-000177 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031217 FILED AS OF DATE: 20040204 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MOWERY THEODORE W CENTRAL INDEX KEY: 0001278504 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 04565891 MAIL ADDRESS: STREET 1: 841 WYNNEWOOD ROAD CITY: CAMP HILL STATE: PA ZIP: 17011 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 3 1 e3803_ex.xml FORM 3 X0201 3 2003-12-17 0 0000879635 MID PENN BANCORP INC MBP 0001278504 MOWERY THEODORE W 841 WYNNEWOOD ROAD CAMP HILL PA 17011 1 0 0 0 Common Stock 115 D /s/ Theodore Mowery 2004-02-04 -----END PRIVACY-ENHANCED MESSAGE-----