0001144204-19-004070.txt : 20190131 0001144204-19-004070.hdr.sgml : 20190131 20190131161127 ACCESSION NUMBER: 0001144204-19-004070 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190129 FILED AS OF DATE: 20190131 DATE AS OF CHANGE: 20190131 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SAMPSON RANDALL D CENTRAL INDEX KEY: 0001042527 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37858 FILM NUMBER: 19556038 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 4 1 tv512144_4.xml OWNERSHIP DOCUMENT X0306 4 2019-01-29 0 0001672909 Canterbury Park Holding Corp CPHC 0001042527 SAMPSON RANDALL D 1100 CANTERBURY ROAD SHAKOPEE MN 55379 1 1 1 0 President and CEO Common Stock 2019-01-29 4 M 0 15000 6.00 A 254209 D Common Stock 2019-01-29 4 F 0 5863 15.35 D 248346 D Common Stock 344000 I By Trust Employee Stock Option (right to buy) 6 2019-01-29 4 M 0 15000 0 D 2012-10-23 2019-04-23 Common Stock 15000 0 D 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 trust]. /s/ Randall D. Sampson 2019-01-31