0001144204-18-016203.txt : 20180321 0001144204-18-016203.hdr.sgml : 20180321 20180321171156 ACCESSION NUMBER: 0001144204-18-016203 CONFORMED SUBMISSION TYPE: 5/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171231 FILED AS OF DATE: 20180321 DATE AS OF CHANGE: 20180321 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SAMPSON RANDALL D CENTRAL INDEX KEY: 0001042527 FILING VALUES: FORM TYPE: 5/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-37858 FILM NUMBER: 18705127 MAIL ADDRESS: STREET 1: 1100 CANTERBURY ROAD CITY: SHAKOPEE STATE: MN ZIP: 55379 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Canterbury Park Holding Corp CENTRAL INDEX KEY: 0001672909 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-RACING, INCLUDING TRACK OPERATION [7948] IRS NUMBER: 475349765 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1100 CANTERBURY ROAD S. CITY: SHAKOPEE STATE: MN ZIP: 55379 BUSINESS PHONE: (952) 445-7223 MAIL ADDRESS: STREET 1: 1100 CANTERBURY ROAD S. CITY: SHAKOPEE STATE: MN ZIP: 55379 FORMER COMPANY: FORMER CONFORMED NAME: New Canterbury Park Holding Corp DATE OF NAME CHANGE: 20160422 5/A 1 tv487236_form5a.xml OWNERSHIP DOCUMENT X0306 5/A 2017-12-31 2018-02-05 0 0 0 0001672909 Canterbury Park Holding Corp CPHC 0001042527 SAMPSON RANDALL D 1100 CANTERBURY ROAD SHAKOPEE MN 55379 1 1 1 0 President & CEO COMMON STOCK 2017-03-31 5 P 0 342 10.550 A 242335 D COMMON STOCK 2017-09-30 5 P 0 178 12.35 A 241513 D COMMON STOCK 2017-12-28 5 G 0 2500 0 D 239013 D COMMON STOCK 2017-12-31 5 P 0 57 16.25 A 239070 D COMMON STOCK 342000 I by Trust The original Form 5 filing indicated an incorrect amount of securities beneficially owned following reported transaction The stock is owned by Marian Arlis Sampson 2012 Irrevocable Trust. The reporting person is a trustee of the Trust and disclaims any beneficial ownership of the stock, except to the extent of the reporting person's pecuniary interest in the shares [held by the trust] /s/ Randall D. Sampson 2018-03-21