0001171843-11-002814.txt : 20110922 0001171843-11-002814.hdr.sgml : 20110922 20110922151309 ACCESSION NUMBER: 0001171843-11-002814 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110922 FILED AS OF DATE: 20110922 DATE AS OF CHANGE: 20110922 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: De Soto Matthew G CENTRAL INDEX KEY: 0001422493 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 111103018 MAIL ADDRESS: STREET 1: 144 CORNELL DRIVE CITY: MILLERSBURG STATE: PA ZIP: 17061 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 form4.xml STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES X0304 4 2011-09-22 0000879635 MID PENN BANCORP INC MPB 0001422493 De Soto Matthew G 650 WEST MARKET STREET GRATZ PA 17030 1 0 0 0 Common Stock 2011-09-22 4 P 0 1500 7.26 A 6593.7658 D /s/ Matthew G. DeSoto 2011-09-22