0000897101-15-000203.txt : 20150218 0000897101-15-000203.hdr.sgml : 20150216 20150217191158 ACCESSION NUMBER: 0000897101-15-000203 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20141231 FILED AS OF DATE: 20150217 DATE AS OF CHANGE: 20150217 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CANTERBURY PARK HOLDING CORP CENTRAL INDEX KEY: 0000926761 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-RACING, INCLUDING TRACK OPERATION [7948] IRS NUMBER: 411775532 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1100 CANTERBURY DR CITY: SHAKOPEE STATE: MN ZIP: 55379 BUSINESS PHONE: 6124457223 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SAMPSON RANDALL D CENTRAL INDEX KEY: 0001042527 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-31569 FILM NUMBER: 15625173 MAIL ADDRESS: STREET 1: 1100 CANTERBURY ROAD CITY: SHAKOPEE STATE: MN ZIP: 55379 5 1 cphc150584rsampson_5.xml FORM 5 X0306 5 2014-12-31 0 0 0 0000926761 CANTERBURY PARK HOLDING CORP CPHC 0001042527 SAMPSON RANDALL D 1100 CANTERBURY ROAD SHAKOPEE MN 55379 1 1 1 0 President, CEO & General Mgr Common Stock 242029 D Common Stock 362700 I by Trust Common Stock 4900 I by Minor Child Includes 6,000 shares subject to unvested deferred stock awards. Reporting person's ownership decreased by 15,900 because one of reporting person's children no longer share a household. 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]. The reporting person disclaims any beneficial interest in the shares owned by his minor child. /s/ Randall D. Sampson 2015-02-17