0001171843-21-004050.txt : 20210602 0001171843-21-004050.hdr.sgml : 20210602 20210602164044 ACCESSION NUMBER: 0001171843-21-004050 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: POOLE WILLIAM KENDALL CENTRAL INDEX KEY: 0001635425 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 21989685 MAIL ADDRESS: STREET 1: C/O S&T BANK ACCOUNTING DEPT STREET 2: 800 PHILADELPHIA STREET CITY: INDIANA STATE: PA ZIP: 15701 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 0001635425 POOLE WILLIAM KENDALL 349 UNION STREET MILLERSBURG PA 17061 1 0 0 0 Mid Penn Bancorp, Inc. Common Stock 2021-06-01 4 A 0 440 0 A 440 D Mid Penn Bancorp, Inc. Common Stock 5000 D Shares granted in the form of restricted stock which vests according to the terms of each respective grant. /s/ William K. Poole 2021-06-02