-----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, SfziPgfsbd0JaeFNtXwp5eOeOqhfQP93MnMnPY/17PzMq8Mtp7QDIe5egxvkMUKN e7kiK19NSObYA9SaqDK8NA== 0001005150-04-000872.txt : 20040408 0001005150-04-000872.hdr.sgml : 20040408 20040408142329 ACCESSION NUMBER: 0001005150-04-000872 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040223 FILED AS OF DATE: 20040408 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DAKEY ALAN W CENTRAL INDEX KEY: 0001253410 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 04724539 BUSINESS ADDRESS: STREET 1: 156 WAGON RD CITY: MILLERSBURG STATE: PA ZIP: 17061 BUSINESS PHONE: 7176922133 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/A 1 e3904ad_ex.xml X0201 4/A 2004-02-23 2004-02-20 0 0000879635 MID PENN BANCORP INC MBP 0001253410 DAKEY ALAN W 156 WAGON RD MILLERSBURG PA 17061 1 1 0 0 President & CEO Common Stock 2004-02-23 4 P 0 0 A 0 D Amendment submited to cancel Form 4 issued for 2/23/04. $2500 transaction to purchase stock was not executed. /s/ Alan W. Dakey 2004-04-08 -----END PRIVACY-ENHANCED MESSAGE-----