0001171843-16-013199.txt : 20161114 0001171843-16-013199.hdr.sgml : 20161111 20161114124732 ACCESSION NUMBER: 0001171843-16-013199 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161107 FILED AS OF DATE: 20161114 DATE AS OF CHANGE: 20161114 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/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 161992883 MAIL ADDRESS: STREET 1: 281 N. OLD STONEHOUSE RD. CITY: CARLISLE STATE: PA ZIP: 17015 4/A 1 formfour.xml OWNERSHIP DOCUMENT X0306 4/A 2016-11-07 2016-11-09 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 P 0 21 18.60 A 2689.48 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 2016-11-14