SEC Form 4 · accession 0000897101-16-003402
Canterbury Park Holding Corp · CPHC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Randall D Sampson
Officer — President, CEO & General Mgr · Director · 10% Owner
Period of report
Dec 21, 2016
Accepted (ET)
Dec 23, 2016 · 9:16 am EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001672909
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Dec 21, 2016 | G | 2,500 | $10.20 | D | 238,415 | D | |
| Common StockF1 | holding | — | — | — | 342,000 | I | By Trust | |
| Common StockF2 | holding | — | — | — | 4,900 | I | By Minor Child |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1The 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].
- F2The reporting person disclaims any beneficial interest in the shares owned by his minor child.