0001171843-21-003049.txt : 20210503 0001171843-21-003049.hdr.sgml : 20210503 20210503161716 ACCESSION NUMBER: 0001171843-21-003049 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210430 FILED AS OF DATE: 20210503 DATE AS OF CHANGE: 20210503 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Peduzzi Michael D CENTRAL INDEX KEY: 0001409722 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 21883781 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 2021-04-30 0 0000879635 MID PENN BANCORP INC MPB 0001409722 Peduzzi Michael D 817 HOUSMAN PLACE LANCASTER PA 17601 0 1 0 0 SEVP/CFO Mid Penn Bancorp, Inc. Common Stock 2021-04-30 4 P 0 750 25.00 A 4388 D Mid Penn Bancorp, Inc. Common Stock 2312 D Mid Penn Bancorp, Inc. Common Stock 2450 I Roth IRA Mid Penn Bancorp, Inc. Common Stock 2300 I IRA Shares granted in the form of Restricted Stock which vests according to the terms of each respective grant. /s/ Michael D. Peduzzi 2021-05-03