0001171843-18-000029.txt : 20180102
0001171843-18-000029.hdr.sgml : 20180102
20180102142736
ACCESSION NUMBER: 0001171843-18-000029
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171229
FILED AS OF DATE: 20180102
DATE AS OF CHANGE: 20180102
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MOWERY THEODORE W
CENTRAL INDEX KEY: 0001278504
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-13677
FILM NUMBER: 18501256
MAIL ADDRESS:
STREET 1: 841 WYNNEWOOD ROAD
CITY: CAMP HILL
STATE: PA
ZIP: 17011
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 STREET
CITY: MILLERSBURG
STATE: PA
ZIP: 17061
BUSINESS PHONE: 8666427736
MAIL ADDRESS:
STREET 1: 349 UNION STREET
CITY: MILLERSBURG
STATE: PA
ZIP: 17061
4
1
formfour.xml
FORM 4
X0306
4
2017-12-29
0
0000879635
MID PENN BANCORP INC
MPB
0001278504
MOWERY THEODORE W
129 SOUTH LEWISBERRY ROAD
MECHANICSBURG
PA
17055
1
0
0
0
Mid Penn Bancorp, Inc. Common Stock
2017-12-29
4
P
0
60
33.10
A
4176.999
D
Mid Penn Bancorp, Inc. Common Stock
6658.615
I
IRA
Mid Penn Bancorp, Inc. Common Stock
400
D
Shares purchased through Director Stock Purchase Plan.
Balance includes shares acquired through Dividend Reinvestment Plan.
Shares granted in the form of restricted stock, which vests 100% on the first anniversary of the date of grant.
/s/ Theodore W. Mowery
2018-01-02