0001171843-21-003991.txt : 20210602
0001171843-21-003991.hdr.sgml : 20210602
20210602142200
ACCESSION NUMBER: 0001171843-21-003991
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210601
FILED AS OF DATE: 20210602
DATE AS OF CHANGE: 20210602
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Grubic Robert C
CENTRAL INDEX KEY: 0001348171
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-13677
FILM NUMBER: 21988704
MAIL ADDRESS:
STREET 1: 4315 STONELEIGH COURT
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
2021-06-01
0
0000879635
MID PENN BANCORP INC
MPB
0001348171
Grubic Robert C
4315 STONELEIGH COURT
HARRISBURG
PA
17112
1
0
0
0
Mid Penn Bancorp, Inc. Common Stock
2021-06-01
4
A
0
703
0
A
1203
D
Mid Penn Bancorp, Inc. Common Stock
52019.619
D
Shares granted in the form of restricted stock which vests according to the terms of each respective grant.
Balance includes shares acquired through the Dividend Reinvestment Plan.
/s/ Robert C. Grubic
2021-06-02