0001171843-16-013074.txt : 20161109
0001171843-16-013074.hdr.sgml : 20161109
20161109114826
ACCESSION NUMBER: 0001171843-16-013074
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20161107
FILED AS OF DATE: 20161109
DATE AS OF CHANGE: 20161109
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: Neiderer Kelly K
CENTRAL INDEX KEY: 0001571102
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-13677
FILM NUMBER: 161983241
MAIL ADDRESS:
STREET 1: 281 N. OLD STONEHOUSE RD.
CITY: CARLISLE
STATE: PA
ZIP: 17015
4
1
formfour.xml
OWNERSHIP DOCUMENT
X0306
4
2016-11-07
0
0000879635
MID PENN BANCORP INC
MPB
0001571102
Neiderer Kelly K
281 N. OLD STONEHOUSE RD.
CARLISLE
PA
17015
0
1
0
0
EVP and Chief Retail Officer
Mid Penn Bancorp, Inc. Common Stock
2016-11-07
4
A
0
21
18.60
A
2710.48
D
Balance includes shares acquired through Employee Stock Purchase Plan and Dividend Reinvestment Plan, and shares granted in the form of restricted stock.
/s/ Kelly K. Neiderer
2016-11-09