0001171843-19-006263.txt : 20191001 0001171843-19-006263.hdr.sgml : 20191001 20191001144829 ACCESSION NUMBER: 0001171843-19-006263 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190930 FILED AS OF DATE: 20191001 DATE AS OF CHANGE: 20191001 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Novak Alan P. CENTRAL INDEX KEY: 0001749981 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 191128791 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 2019-09-30 0 0000879635 MID PENN BANCORP INC MPB 0001749981 Novak Alan P. 349 UNION STREET MILLERSBURG PA 17061 1 0 0 0 Mid Penn Bancorp, Inc. Common Stock 2019-09-30 4 P 0 23 25.63 A 3812.921 D Mid Penn Bancorp, Inc. Common Stock 5221 I IRA 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/ Alan P. Novak 2019-10-01