SEC Form 4 · accession 0001171843-15-001182
MID PENN BANCORP INC · MPB
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Robert J Moisey
Director
Period of report
Mar 1, 2015
Accepted (ET)
Mar 2, 2015 · 4:54 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000879635
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Mid Penn Bancorp, Inc. Common StockF1 | Mar 1, 2015 | A | 11,368 | — | A | 11,368 | D | |
| Mid Penn Bancorp, Inc. Common StockF2 | Mar 1, 2015 | A | 259 | — | A | 11,627 | D | |
| Mid Penn Bancorp, Inc. Common StockF1 | Mar 1, 2015 | A | 2,036 | — | A | 2,036 | I | By Spouse |
| Mid Penn Bancorp, Inc. Common StockF2 | Mar 1, 2015 | A | 259 | — | A | 2,295 | I | By Spouse |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Each share of Phoenix Bancorp, Inc. common stock was exchanged in connection with the merger with Mid Penn Bancorp, Inc. ("MPB") for either 3.167 shares of MPB common stock or $51.60 in cash.
- F2Each Phoenix Contingent Right was exchanged in connection with the merger with MPB for 0.4136 shares of MPB common stock.