0001171843-23-003518.txt : 20230523
0001171843-23-003518.hdr.sgml : 20230523
20230523153511
ACCESSION NUMBER: 0001171843-23-003518
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230519
FILED AS OF DATE: 20230523
DATE AS OF CHANGE: 20230523
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: GUMINA FRANK JR
CENTRAL INDEX KEY: 0001256425
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-13677
FILM NUMBER: 23948758
MAIL ADDRESS:
STREET 1: 98 FAIRWAY BLVD
CITY: MONROE TOWNSHIP
STATE: NJ
ZIP: 08831
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
X0407
4
2023-05-19
0
0000879635
MID PENN BANCORP INC
MPB
0001256425
GUMINA FRANK JR
2407 PARK DRIVE
HARRISBURG
PA
17110
1
0
0
0
0
Mid Penn Bancorp, Inc. Common Stock
2023-05-19
4
A
0
17299
0
A
17799
D
Mid Penn Bancorp, Inc. Common Stock
2023-05-19
4
A
0
4001
0
A
4001
I
Company-owned
Mid Penn Bancorp, Inc. Common Stock
2023-05-19
4
A
0
1242
0
A
1242
I
By spouse
Acquired pursuant to the Agreement and Plan of Merger, dated as of December 20, 2022 (the Merger Agreement), by and between Mid Penn Bancorp, Inc. (MPB) and Brunswick Bancorp (Brunswick), pursuant to which Brunswick merged with and into MPB, with MPB continuing as the surviving corporation (Merger), on May 19, 2023. Pursuant to the Merger Agreement, at the effective time of the Merger (the Effective Time), each share of common stock of Brunswick held by Mr. Gumina immediately prior to the Effective Time that was not converted into cash was converted into the right to receive 0.598 shares of MPB common stock.
Shares held in the name of Franina Associates, LLC.
/s/ Frank Gumina, Jr.
2023-05-23