0001171843-22-000042.txt : 20220104 0001171843-22-000042.hdr.sgml : 20220104 20220104110353 ACCESSION NUMBER: 0001171843-22-000042 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211231 FILED AS OF DATE: 20220104 DATE AS OF CHANGE: 20220104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MOWERY THEODORE W CENTRAL INDEX KEY: 0001278504 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13677 FILM NUMBER: 22504574 MAIL ADDRESS: STREET 1: 2407 PARK DRIVE CITY: HARRISBURG STATE: PA ZIP: 17110 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: 2407 PARK DRIVE CITY: HARRISBURG STATE: PA ZIP: 17110 BUSINESS PHONE: 8666427736 MAIL ADDRESS: STREET 1: 2407 PARK DRIVE CITY: HARRISBURG STATE: PA ZIP: 17110 4 1 ownership.xml X0306 4 2021-12-31 0 0000879635 MID PENN BANCORP INC MPB 0001278504 MOWERY THEODORE W 2407 PARK DR. HARRISBURG PA 17110 1 0 0 0 Mid Penn Bancorp, Inc. Common Stock 2021-12-31 4 P 0 63 31.74 A 18873.218 D Mid Penn Bancorp, Inc. Common Stock 7773.924 I IRA Mid Penn Bancorp, Inc. Common Stock 703 D Shares purchased through the Director Stock Purchase Plan. Balance includes shares acquired through the Dividend Reinvestment Plan. Shares granted in the form of restricted stock, which vests 100% on the first anniversary of the date of grant. /s/ Theodore W. Mowery 2022-01-04