0001171843-18-000034.txt : 20180102
0001171843-18-000034.hdr.sgml : 20180102
20180102151726
ACCESSION NUMBER: 0001171843-18-000034
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: Grubic Robert C
CENTRAL INDEX KEY: 0001348171
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-13677
FILM NUMBER: 18501488
MAIL ADDRESS:
STREET 1: 4315 STONELEIGH COURT
CITY: HARRISBURG
STATE: PA
ZIP: 17112
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
form4grubic.xml
OWNERSHIP DOCUMENT
X0306
4
2017-12-29
0
0000879635
MID PENN BANCORP INC
MPB
0001348171
Grubic Robert C
4315 STONELEIGH COURT
HARRISBURG
PA
17112
1
0
0
0
Mid Penn Bancorp, Inc. Common Stock
2017-12-29
4
P
0
151
33.10
A
38638.019
D
Mid Penn Bancorp, Inc. Common Stock
400
D
Shares purchased through the Director Stock Purchase Plan.
Balance includes shares acquired through the Dividend Reinvestment Plan.
Shares granted in the form of restricted stock, which vests 100% on the first anniversary of the date of grant.
/s/ Robert C. Grubic
2018-01-02