SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
MONTICELLO REALTY LLC

(Last) (First) (Middle)
C/O MONTICELLO RACEWAY
ROUTE 17B

(Street)
MONTICELLO NY 12701

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/12/2004
3. Issuer Name and Ticker or Trading Symbol
EMPIRE RESORTS INC [ NYNY ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock, $.01 par value per share 5,732,261(1) D(2)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
1. Name and Address of Reporting Person*
MONTICELLO REALTY LLC

(Last) (First) (Middle)
C/O MONTICELLO RACEWAY
ROUTE 17B

(Street)
MONTICELLO NY 12701

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
DABBAH MAURICE

(Last) (First) (Middle)
C/O MONTICELLO RACEWAY
ROUTE 17B

(Street)
MONTICELLO NY 12701

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
MANHATTAN DEVELOPMENT CORP

(Last) (First) (Middle)
C/O MONTICELLO RACEWAY
ROUTE 17B

(Street)
MONTICELLO NY 12701

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. These shares of common stock of the Issuer were issued to Monticello Realty, L.L.C. ("MR") in consideration for MR's holdings in Monticello Casino Management, LLC, Mohawk Management, LLC and Monticello Raceway Management, Inc. pursuant to that certain Amended and Restated Securities Contribution Agreement, dated as of December 12, 2003. The aggregate market value of these holdings, based on the market price of the consideration received at closing ($9.10 per share), was $52,163,575.10.
2. This Form 3 is filed jointly by Maurice Dabbah, Manhattan Development Corp. ("MDC") and MR. Mr. Dabbah and MDC are deemed to be 10% owners of the Issuer and MR is a 10% owner of the Issuer. The securities reported in this Form 3 are owned directly by MR, and owned indirectly by MDC by virtue of it being the manager of MR and by Mr. Dabbah by virtue of his position as the President of MDC. MDC and Mr. Dabbah disclaim beneficial ownership of the Shares owned by MR except to the extent of their pecuniary interest therein.
Remarks:
By: Monticello Realty L.L.C., By: Manhattan Development Corp., Manager, By: /s/ Maurice Dabbah, President 01/13/2004
/s/ Dabbah, Maurice 01/13/2004
By: Manhattan Development Corp., By: /s/ Maurice Dabbah, President 01/13/2004
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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