0001171843-20-005253.txt : 20200727 0001171843-20-005253.hdr.sgml : 20200727 20200727110233 ACCESSION NUMBER: 0001171843-20-005253 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200724 FILED AS OF DATE: 20200727 DATE AS OF CHANGE: 20200727 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Specht William A III CENTRAL INDEX KEY: 0001348170 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 201049331 MAIL ADDRESS: STREET 1: 202 NELSON TERRACE 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 2020-07-24 0 0000879635 MID PENN BANCORP INC MPB 0001348170 Specht William A III 144 CORNELL DRIVE MILLERSBURG PA 17061 1 0 0 0 Mid Penn Bancorp, Inc. Common Stock 2020-07-24 4 A 0 500 0 A 5605 D Mid Penn Bancorp, Inc. Common Stock 4900 I By entity wholly-owned Mid Penn Bancorp, Inc. Common Stock 2235 I IRA Mid Penn Bancorp, Inc. Common Stock 31210 I Trustee Shares granted in the form of restricted stock, which vests 100% on the first anniversary of the date of grant. Represents shares held by Seal Glove Manufacturing, Inc., an entity wholly-owned by the Reporting Person. William A. Specht, III is trustee of a family trust of which the shares are held for the benefit of Janet E. Specht. /s/ William A. Specht, III 2020-07-27