0001171843-21-004047.txt : 20210602
0001171843-21-004047.hdr.sgml : 20210602
20210602163756
ACCESSION NUMBER: 0001171843-21-004047
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: Micklewright Scott W
CENTRAL INDEX KEY: 0001494991
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-13677
FILM NUMBER: 21989648
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
2021-06-01
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
2021-06-01
4
A
0
703
0
A
3515
D
Mid Penn Bancorp, Inc. Common Stock
8624.948
D
Shares granted in the form of restricted stock which vests according to the terms of each respective grant.
Balance includes shares acquired through Employee Stock Purchase Plan and Dividend Reinvestment Plan.
/s/ Scott W. Micklewright
2021-06-02