0001171843-18-005365.txt : 20180725
0001171843-18-005365.hdr.sgml : 20180725
20180725070419
ACCESSION NUMBER: 0001171843-18-005365
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180725
FILED AS OF DATE: 20180725
DATE AS OF CHANGE: 20180725
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: RITRIEVI RORY G
CENTRAL INDEX KEY: 0001230831
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-13677
FILM NUMBER: 18967649
MAIL ADDRESS:
STREET 1: 1019 TUNBRIDGE LANE
CITY: MECHANICSBURG
STATE: PA
ZIP: 17050
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
ownership.xml
X0306
4
2018-07-25
0
0000879635
MID PENN BANCORP INC
MPB
0001230831
RITRIEVI RORY G
1019 TUNBRIDGE LANE
MECHANICSBURG
PA
17050
1
1
0
0
President and CEO
Mid Penn Bancorp, Inc. Common Stock
2018-07-25
4
A
0
2000
0
A
16372.757
D
Mid Penn Bancorp, Inc. Common Stock
3550.981
I
IRA
Shares granted in the form of restricted stock, which vests, subject to acceleration upon certain occurrences, 25% on each anniversary of the date of grant (each, a "vesting tranche"), but only if such reporting person remains continuously employed through the applicable anniversary date.
Balance includes shares acquired through Employee Stock Purchase Plan and Dividend Reinvestment Plan and shares granted in the form of restricted stock.
Balance includes shares acquired through Dividend Reinvestment Plan.
/s/ Rory G. Ritrievi
2018-07-25