SEC Form 4 · accession 0001144204-18-004858
Canterbury Park Holding Corp · CPHC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Curtis A Sampson
Director · 10% Owner
Period of report
Jan 31, 2018
Accepted (ET)
Jan 31, 2018 · 2:42 pm 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 | Jan 31, 2018 | M | 3,000 | $11.35 | A | 508,403 | D | |
| Common StockF1 | holding | — | — | — | 342,000 | I | By Trust | |
| Common StockF2 | holding | — | — | — | 11,300 | I | By Spouse |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Non-Qualified Stock OptionF3 | $11.35 | Jan 31, 2018 | M | 3,000 | D | Aug 1, 2008 | Feb 1, 2018 | Common Stock | 3,000 | 9,000 | D |
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 benefical interest in the shares owned by his spouse.
- F3Not applicable to non-qualified stock option grant.