0001171843-21-004042.txt : 20210602 0001171843-21-004042.hdr.sgml : 20210602 20210602162714 ACCESSION NUMBER: 0001171843-21-004042 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: Peduzzi Michael D CENTRAL INDEX KEY: 0001409722 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 21989472 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 2021-06-01 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 2021-06-01 4 A 0 703 0 A 3015 D Mid Penn Bancorp, Inc. Common Stock 4388 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 2021-06-02