0001171843-21-008297.txt : 20211202
0001171843-21-008297.hdr.sgml : 20211202
20211202155115
ACCESSION NUMBER: 0001171843-21-008297
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211130
FILED AS OF DATE: 20211202
DATE AS OF CHANGE: 20211202
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Kerwin Joseph D.
CENTRAL INDEX KEY: 0001749452
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-13677
FILM NUMBER: 211466473
MAIL ADDRESS:
STREET 1: 100 IRISH ROAD
CITY: LYKENS
STATE: PA
ZIP: 17048
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
2021-11-30
0
0000879635
MID PENN BANCORP INC
MPB
0001749452
Kerwin Joseph D.
349 UNION STREET
MILLERSBURG
PA
17061
1
0
0
0
Mid Penn Bancorp, Inc. Common Stock
2021-11-30
4
A
0
21085
0
A
49085.076
D
Acquired pursuant to the Agreement and Plan of Merger, dated as of June 30, 2021, and amended on August 26, 2021 (the Merger Agreement), by and between Mid Penn Bancorp, Inc. (MPB) and Riverview Financial Corporation (RIVE), pursuant to which RIVE merged with and into MPB, with MPB continuing as the surviving corporation (Merger), on November 30, 2021. Pursuant to the Merger Agreement, at the effective time of the Merger (the Effective Time), each share of the common stock of RIVE issued and outstanding immediately prior to the Effective Time was converted into the right to receive 0.4833 shares of common stock of MPB.
/s/ Joseph D. Kerwin
2021-12-02