0001171843-19-000935.txt : 20190214 0001171843-19-000935.hdr.sgml : 20190214 20190214163842 ACCESSION NUMBER: 0001171843-19-000935 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190213 FILED AS OF DATE: 20190214 DATE AS OF CHANGE: 20190214 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Peduzzi Michael D CENTRAL INDEX KEY: 0001409722 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 19607363 MAIL ADDRESS: STREET 1: 349 UNION STREET CITY: MILLERSBURG STATE: PA ZIP: 17061 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 2019-02-13 0 0000879635 MID PENN BANCORP INC MPB 0001409722 Peduzzi Michael D 817 HOUSMAN PLACE LANCASTER PA 17601 0 1 0 0 SEVP/CFO Mid Penn Bancorp, Inc. Common Stock 2019-02-13 4 P 0 100 23.19 A 2200 I IRA Mid Penn Bancorp, Inc. Common Stock 2019-02-13 4 P 0 100 23.18 A 2350 I Roth IRA Mid Penn Bancorp, Inc. Common Stock 2250 D Balance includes shares granted in the form of restricted stock. /s/ Michael D. Peduzzi 2019-02-14