0001144204-18-005664.txt : 20180205 0001144204-18-005664.hdr.sgml : 20180205 20180205142933 ACCESSION NUMBER: 0001144204-18-005664 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171231 FILED AS OF DATE: 20180205 DATE AS OF CHANGE: 20180205 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: 001-37858 FILM NUMBER: 18573819 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 1 tv484895_form5.xml FORM 5 X0306 5 2017-12-31 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 242113 D COMMON STOCK 2017-09-30 5 P 0 178 12.35 A 242291 D COMMON STOCK 2017-12-28 5 G 0 2500 15.965 D 244791 D COMMON STOCK 2017-12-31 5 P 0 57 16.25 A 244848 D COMMON STOCK 342000 I by Trust COMMON STOCK 4900 I by Minor Child Average high and low share price for 12/28/17 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 2018-01-31