Form 8-A
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FOR REGISTRATION OF CERTAIN CLASSES OF SECURITIES
PURSUANT TO SECTION 12(b) OR (g) OF THE
SECURITIES EXCHANGE ACT OF 1934
Mid Penn Bancorp, Inc.
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[Exact name of registrant as specified in it charter]
Pennsylvania 25-1666413
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(State of incorporation (I.R.S. Employer
organization ) Identification No.)
349 Union Street, Millersburg, Pennsylvania 17061
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(Address of principal executive offices) (Zip Code)
Securities to be registered pursuant to Section 12(b) of the Act:
Common Stock American Stock Exchange
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Title of each class Name of each exchange on which
to be so registered each class is to be registered
If this form relates to the registration of a class of
securities pursuant to Section 12(b) of the Exchange Act and is
effective pursuant to General Instruction A.(c), check the
following box. X
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If this form relates to the registration of a class of
securities pursuant to Section 12(g) of the Exchange Act and is
effective pursuant to General Instruction A.(d), check the
following box.
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Securities Act registration statement file number to which
this form relates: N/A
Securities to be registered pursuant to Section 12(g) of the
Act:
None
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(Title of class)
Not Applicable
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(Title of class)
Page 1 of 4
Sequentially Numbered Pages
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Item 1. Description of Registrant's Securities to be Registered.
The information required herein is incorporated by reference
to the Registrant's Registration Statement No. 33-42938 on
Form S-4 , filed with the Securities and Exchange Commission
on September 30, 1991.
Item 2. Exhibits.
The following Exhibits are filed herewith, or incorporated
by reference as a part of this Report:
3(i) Registrant's Articles of Incorporation. (Incorporated
by reference to Exhibit 3(i) to Registrant's Annual
Report on Form 10-K for the year ended December 31,
1996, filed with the Securities and Exchange
Commission on March 24, 1997.
3(ii) Registrant's By-laws.(Incorporated by reference to
Exhibit 3(ii) to Registrant's Annual Report on Form
10-K for the year ended December 31, 1996, filed with
the Securities and Exchange Commission on March 24,
1997.
2
<PAGE>
SIGNATURE
Pursuant to the requirements of Section 12 of the Securities
Exchange Act of 1934, as amended, the Registrant has duly caused
this Registration Statement to be signed on its behalf by the
undersigned, thereunto duly authorized.
MID PENN BANCORP, INC.
(Registrant)
Dated: November 17, 1997 By /s/ Eugene F. Shaffer
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Eugene F. Shaffer
Chairman of the Board of
Directors, President and Chief
Executive Officer
<PAGE>
EXHIBIT INDEX
Sequential Page
Number in Manually
Exhibit Number Signed Original
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3(i) Registrant's Articles of Incorporation.
(Incorporated by reference to
Exhibit 3(i) to Registrant's Annual
Report on Form 10-K for the year
ended December 31, 1996, filed with
the Securities and Exchange Commission
on March 24, 1997.
3(ii) Registrant's By-laws.(Incorporated by
reference to Exhibit 3(ii) to
Registrant's Annual Report on Form 10-K
for the year ended December 31, 1996,
filed with the Securities and Exchange
Commission on March 24, 1997.
4
