0001354488-11-001363.txt : 20110505 0001354488-11-001363.hdr.sgml : 20110505 20110505090314 ACCESSION NUMBER: 0001354488-11-001363 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110502 FILED AS OF DATE: 20110505 DATE AS OF CHANGE: 20110505 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: 11812670 MAIL ADDRESS: STREET 1: 841 WYNNEWOOD ROAD CITY: CAMP HILL STATE: PA ZIP: 17011 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 ST CITY: MILLERSBURG STATE: PA ZIP: 17061 BUSINESS PHONE: 7176922133 MAIL ADDRESS: STREET 1: 349 UNION STREET STREET 2: 349 UNION STREET CITY: MILLERSBURG STATE: PA ZIP: 17061 4 1 issuerdirect_section16.xml PRIMARY DOCUMENT X0303 4 2011-05-02 0 0000879635 MID PENN BANCORP INC MPB 0001278504 MOWERY THEODORE W 129 SOUTH LEWISBERRY ROAD MECHANICSBURG PA 17055 1 Common Stock 2011-05-02 5 J 0 140 9.00 A 4140 D Common Stock 2011-05-03 5 J 0 100 9.00 A 4240 D Common Stock 3381.443 D Purchased in an IRA Account. Shares held Individually. /s/ Theodore W. Mowery 2011-05-02