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SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
SCHEDULE 13G
UNDER THE SECURITIES EXCHANGE ACT OF 1934
(AMENDMENT NO. 2 )*
Canterbury Park Holding Corporation
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(Name of Issuer)
Common Stock, Par Value $0.01
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(Title of Class of Securities)
13811E 10 1
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(CUSIP Number)
*The remainder of this cover page shall be filled out for a reporting
person's initial filing on this form with respect to the subject class of
securities, and for any subsequent amendment containing information which
would alter the disclosures provided in a prior cover page.
The information required in the remainder of this cover page shall not be
deemed to be "filed" for the purpose of Section 18 of the Securities
Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of
that section of the Act but shall be subject to all other provisions of the
Act (however, see the Notes).
(Continued on following page(s))
Page 1 of 4
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CUSIP No. 13811E 10 1 13G Page 2 of 4 Pages
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(1) NAMES OF REPORTING PERSON
S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS
Curtis A. Sampson
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(2) Check the Appropriate Box if a Member of a Group*
(a) / /
(b) / /
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(3) SEC Use Only
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(4) Citizenship or Place of Organization
United States of America
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Number of Shares (5) Sole Voting Power
Beneficially 1,385,531
Owned by --------------------------------------------------
Each Reporting (6) Shared Voting Power
Person With 0
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(7) Sole Dispositive Power
1,385,531
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(8) Shared Dispositive Power
0
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(9) Aggregate Amount Beneficially Owned by Each Reporting Person
1,385,531
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(10) Check Box if the Aggregate Amount in Row (9) Excludes Certain Shares*
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(11) Percent of Class Represented by Amount in Row (9)
35.2%
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(12) Type of Reporting Person*
IN
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*SEE INSTRUCTION BEFORE FILLING OUT!
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Item 1.
(a) NAME OF ISSUER
Canterbury Park Holding Corporation, a Minnesota corporation
(b) ADDRESS OF ISSUER'S PRINCIPAL EXECUTIVE OFFICES
Canterbury Park Holding Corporation, 1100 Canterbury Drive, Shakopee,
MN 55379.
Item 2.
(a) NAME OF PERSON FILING. This statement is being filed by Curtis A.
Sampson, an individual.
(b) ADDRESS OF PRINCIPAL BUSINESS OFFICE OR, IF NONE, RESIDENCE. The
principal address of Mr. Sampson is 1100 Canterbury Drive, Shakopee,
MN 55379.
(c) CITIZENSHIP. Mr. Sampson is an American citizen.
(d) TITLE OF CLASS OF SECURITIES. Common Stock, $0.01 par value per
share.
(e) CUSIP NUMBER. 13811E 10 1
Item 3. IF THIS STATEMENT IS FILED PURSUANT TO RULE 13d-1(b), OR
13d-2(b), CHECK WHETHER THE PERSON FILING IS A:
Not applicable.
Item 4. OWNERSHIP
The following ownership of Mr. Sampson as of December 31, 1996 was as
follows:
(a) Amount Beneficially Owned 1,385,531
(b) Percent of Voting Shares Outstanding 35.2%
(c) Number of shares as to which person has:
(i) Sole power to vote or direct the vote: 1,385,531
(ii) Shared power to vote or direct the vote: 0
(iii) Sole power to dispose or direct the disposition of: 1,385,531
(iv) Shared power to dispose or direct the disposition of: 0
The shares listed above include 1,042,328 shares owned by Mr. Sampson
directly and 343,203 shares issuable upon the exercise of currently issuable
options and warrants.
Item 5. OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS
Not Applicable.
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Item 6. OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON
Not Applicable.
Item 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE
SECURITY REPORTED ON BY THE PARENT HOLDING COMPANY.
Not Applicable.
Item 8. IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP
Not Applicable.
Item 9. NOTICE OF DISSOLUTION OF GROUP
Not Applicable.
Item 10. CERTIFICATES
Not Applicable.
SIGNATURES
After reasonable inquiry and to the best of my knowledge and belief, I
certify that the information set forth in this Statement is true, complete and
correct.
February 14, 1997
/s/ Curtis A. Sampson
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Curtis A. Sampson
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