0001171843-20-008738.txt : 20201222 0001171843-20-008738.hdr.sgml : 20201222 20201222120107 ACCESSION NUMBER: 0001171843-20-008738 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201222 FILED AS OF DATE: 20201222 DATE AS OF CHANGE: 20201222 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Micklewright Scott W CENTRAL INDEX KEY: 0001494991 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 201406852 MAIL ADDRESS: STREET 1: 7742 MANADA CREEK DRIVE CITY: HARRISBURG STATE: PA ZIP: 17112 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 2020-12-22 0 0000879635 MID PENN BANCORP INC MPB 0001494991 Micklewright Scott W 7742 MANADA CREEK DRIVE HARRISBURG PA 17112 0 1 0 0 SEVP and Chief Revenue Officer Mid Penn Bancorp, Inc. Common Stock 2020-12-22 4 A 0 1000 0 A 10720.737 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 Employee Stock Purchase Plan and Dividend Reinvestment Plan and shares granted in the form of restricted stock. /s/ Scott W. Micklewright 2020-12-22