0001171843-13-002301.txt : 20130529
0001171843-13-002301.hdr.sgml : 20130529
20130529155550
ACCESSION NUMBER: 0001171843-13-002301
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20130522
FILED AS OF DATE: 20130529
DATE AS OF CHANGE: 20130529
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: PASSAMONTE JANNA L
CENTRAL INDEX KEY: 0001578057
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-13677
FILM NUMBER: 13878318
MAIL ADDRESS:
STREET 1: 49 PHEASANT HILL DRIVE
CITY: HALIFAX
STATE: PA
ZIP: 17032
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
form3.xml
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
X0206
3
2013-05-22
0
0000879635
MID PENN BANCORP INC
MPB
0001578057
PASSAMONTE JANNA L
49 PHEASANT HILL DRIVE
HALIFAX
PA
17032
0
1
0
0
SVP, Sr Operations Officer
Mid Penn Bancorp, Inc. Common Stock
128.0147
D
/s/ Janna L. Passamonte
2013-05-28