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