-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, FPKc0NHx0GKEAE+2sVj23Y2KkJXlk8VeHAaIs6Zhcp/riR2uK8Zcu7AxgrBY42Hy wrN8XG1uCFeNryW+J7Pw+g== 0001243424-04-000001.txt : 20040113 0001243424-04-000001.hdr.sgml : 20040113 20040113110706 ACCESSION NUMBER: 0001243424-04-000001 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031130 FILED AS OF DATE: 20040113 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MORTGOMERY SANDRA S CENTRAL INDEX KEY: 0001243424 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19932 FILM NUMBER: 04521945 MAIL ADDRESS: STREET 1: 136 CHESTERFIELD INDUSTRIAL BLVD CITY: GHESTERFIELD STATE: MO ZIP: 63005 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: RELIV INTERNATIONAL INC CENTRAL INDEX KEY: 0000768710 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 371172197 STATE OF INCORPORATION: IL FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 136 CHESTERFIELD INDUSTRIAL BLVD STREET 2: P O BOX 405 CITY: CHESTERFIELD STATE: MO ZIP: 63006-0405 BUSINESS PHONE: 3145379715 MAIL ADDRESS: STREET 1: 136 CHESTERFIELD INDUSTRIAL BLVD STREET 2: P O BOX 405 CITY: CHESTERFIELD STATE: MO ZIP: 63006-0405 FORMER COMPANY: FORMER CONFORMED NAME: AMERICAN LIFE INVESTORS INC DATE OF NAME CHANGE: 19920315 4 1 edgar.xml PRIMARY DOCUMENT X0201 42003-11-30 0000768710 RELIV INTERNATIONAL INC RELV 0001243424 MORTGOMERY SANDRA S 136 CHESTERFIELD INDUSTRIAL BOULEVARD CHESTERFIELD MO 63005 1010Common Stock2003-11-305J02665.76A3309838Iby husbandCommon Stock2003-12-315J02675.75A3310105Iby husbandCommon Stock139461DExempt purchase through Company 401(k) plan, 90,428 shares owned in plan through 11/30/03.Exempt purchase through Company 401(k) plan, 90,695 shares owned in plan through 12/31/03.Sandra Montgomery, by John M. Klimek pursuant to a lawful power of attorney previously filed with Commission2004-01-13 -----END PRIVACY-ENHANCED MESSAGE-----