0001144204-19-013496.txt : 20190312 0001144204-19-013496.hdr.sgml : 20190312 20190312153504 ACCESSION NUMBER: 0001144204-19-013496 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190308 FILED AS OF DATE: 20190312 DATE AS OF CHANGE: 20190312 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: 19675008 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 tv516070_4.xml OWNERSHIP DOCUMENT X0306 4 2019-03-08 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 2019-03-08 4 M 0 4722 14.10 A 253068 D Common Stock 2019-03-08 4 F 0 1495 14.10 D 251573 D Common Stock 344000 I By Trust 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]. The reporting person has elected to satisfy his tax withholding obligation in connection with a deferred stock grant by directing the Company to withhold shares otherwise issuable pursuant to the previously reported grant. /s/ Randall D. Sampson 2019-03-12