0001171843-13-004773.txt : 20131122
0001171843-13-004773.hdr.sgml : 20131122
20131122125008
ACCESSION NUMBER: 0001171843-13-004773
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20131121
FILED AS OF DATE: 20131122
DATE AS OF CHANGE: 20131122
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: LAUDENSLAGER KEVIN W
CENTRAL INDEX KEY: 0001253420
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-13677
FILM NUMBER: 131237561
4
1
form4.xml
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
X0306
4
2013-11-21
0000879635
MID PENN BANCORP INC
MPB
0001253420
LAUDENSLAGER KEVIN W
2518 NORTH 2ND STREET
HARRISBURG
PA
17110
0
1
0
0
Vice President and Treasurer
Mid Penn Bancorp, Inc. Common Stock
2013-11-21
4
J
0
2208.5984
A
2208.5984
I
IRA
Mid Penn Bancorp, Inc. Common Stock
200
I
IRA
Mid Penn Bancorp, Inc. Common Stock
2201.6868
D
Shares distributed from employee's account pursuant to dissolution of Employee Stock Ownership Plan. Shares were acquired over various dates.
Balance includes shares acquired through Employee Stock Purchase Plan and Dividend Reinvestment Plan
/s/ Kevin W. Laudenslager
2013-11-22