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