0001171843-19-004863.txt : 20190725 0001171843-19-004863.hdr.sgml : 20190725 20190725092732 ACCESSION NUMBER: 0001171843-19-004863 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: Paese Joseph L CENTRAL INDEX KEY: 0001672207 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 19972802 MAIL ADDRESS: STREET 1: 1416 FARMHOUSE LANE CITY: MIDDLETOWN STATE: PA ZIP: 17057 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 0001672207 Paese Joseph L 1416 FARMHOUSE LANE MIDDLETOWN PA 17057 0 1 0 0 EVP, Dir. Trust, Wealth Mgmt Mid Penn Bancorp, Inc. Common Stock 2019-07-25 4 A 0 500 0 A 3000 D Mid Penn Bancorp, Inc. Common Stock 2125.8545 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 granted in the form of restricted stock. Balance includes shares acquired through Dividend Reinvestment Plan. /s/ Joseph L. Paese 2019-07-25