-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, K5q0te+RHKzARWkKDzrlJ4PecTCcTV1sFtNMzoV01OZzs7Zjmi6lmU1T1Kxq23xg nJGl3JuTCw6K5I5xRMUuAw== 0000941310-02-000004.txt : 20021122 0000941310-02-000004.hdr.sgml : 20021122 20021121174148 ACCESSION NUMBER: 0000941310-02-000004 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20021113 FILED AS OF DATE: 20021122 SUBJECT COMPANY: 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 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-24554 FILM NUMBER: 02836600 BUSINESS ADDRESS: STREET 1: 1100 CANTERBURY DR CITY: SHAKOPEE STATE: MN ZIP: 55379 BUSINESS PHONE: 6124457223 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: SAMPSON CURTIS A CENTRAL INDEX KEY: 0000941310 RELATIONSHIP: OWNER FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: PO BOX 777 STREET 2: 213 MAIN ST CITY: HECTOR STATE: MN ZIP: 55342 BUSINESS PHONE: 3208486231 MAIL ADDRESS: STREET 1: PO BOX 777 STREET 2: S MAIN ST CITY: HECTOR STATE: MN ZIP: 55342 4 1 cas4trak.txt CURTIS A. SAMPSON - TRAK - 11-13-2002 UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 4 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP ( ) Check this box if no longer subject to Section 16. Form 4 or Form 5 Obligations may continue. See Instruction 1(b). 1. Name and Address of Reporting Person: SAMPSON, CURTIS A. 50 PARKVIEW LANE HECTOR, MN 55342 USA 2. Issuer Name and Ticker or Trading Symbol CANTERBURY PARK HOLDING CORP. TRAK 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Statement for Month/Year NOVEMBER, 2002 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all Applicable): (X) Director (X) 10% Owner (X) Officer (give title below) ( ) Other (specify below) CHAIRMAN 7. Individual of Joint/Group Filing (Check Applicable Line) (X) Form filed by One Reporting Person ( ) Form filed by more than One Reporting Person
- ------------------------------------------------------------------------------------------------------------------------------------ Table I - Non-derivative Securities Acquired, Disposed of, or Beneficially Owned - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Transaction 3. Transaction 4. Securities 5. Amount of 6. Ownership 7. Nature of Date Code Acquired (A) or Securities Form: Direct Indirect Disposed of (D) Beneficialy Owned (D) or Beneficial at End of Month Indirect (I) Ownership --------------- (A) or Code V Amount (D) Price - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 11/13/2002 G 1,930 D 1,005,845 D 11,000 I Spouse
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned - ------------------------------------------------------------------------------------------------------------------------------------ 1.Title of 2.Conver- 3.Trans- 4.Trans- 5.Number of 6.Date 7.Title and 8.Price 9.Number of 10.Ownership 11.Nature of Derivative sion or action action Derivative Exercis- Amount of of Derivative Form of Indirect Security Exercise Date Code Securities able and Underlying Deriva Securities Derivative Beneficial Price of Acquired Expira- Securities tive Beneficially Securities Ownership Deriv- (A) or tion Security Owned at Beneficially ative Disposed Date End of Owned at Security of (D) Month End of Month ------------------------------------------------ Amount Date or Exer- Expir Number cis- ation of Code V (A) (D) able Date Title Shares - ------------------------------------------------------------------------------------------------------------------------------------ Common N/A
Explanation of Responses: Signature of Reporting Person /s/ CURTIS A. SAMPSON Date NOVEMBER 21, 2002 -----END PRIVACY-ENHANCED MESSAGE-----