0001171843-19-004849.txt : 20190725 0001171843-19-004849.hdr.sgml : 20190725 20190725090510 ACCESSION NUMBER: 0001171843-19-004849 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190725 FILED AS OF DATE: 20190725 DATE AS OF CHANGE: 20190725 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KERWIN GREGORY M CENTRAL INDEX KEY: 0001253413 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 19972683 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 2019-07-25 0 0000879635 MID PENN BANCORP INC MPB 0001253413 KERWIN GREGORY M 200 IRISH ROAD LYKENS PA 17048 1 0 0 0 Mid Penn Bancorp, Inc. Common Stock 2019-07-25 4 A 0 400 0 A 31745.159 D Shares granted in the form of restricted stock, which vests 100% on the first anniversary of the date of grant. Balance includes shares acquired through the Dividend Reinvestment Plan. /s/ Gregory M. Kerwin 2019-07-25