0001171843-23-003716.txt : 20230602 0001171843-23-003716.hdr.sgml : 20230602 20230602140647 ACCESSION NUMBER: 0001171843-23-003716 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230601 FILED AS OF DATE: 20230602 DATE AS OF CHANGE: 20230602 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: 23987887 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 X0407 4 2023-06-01 0 0000879635 MID PENN BANCORP INC MPB 0001278504 MOWERY THEODORE W 2407 PARK DR. HARRISBURG PA 17110 1 0 0 0 0 Mid Penn Bancorp, Inc. Common Stock 2023-06-01 4 A 0 1760 0 A 1760 D Mid Penn Bancorp, Inc. Common Stock 19326.391 I IRA Mid Penn Bancorp, Inc. Common Stock 28458.009 D Mid Penn Bancorp, Inc. Common Stock 250 I By spouse Shares granted in the form of restricted stock, which vests 100% on the first anniversary of the date of grant. Balance includes shares acquired through the Dividend Reinvestment Plan. /s/ Theodore W. Mowery 2023-06-02