0001072613-16-000973.txt : 20161117 0001072613-16-000973.hdr.sgml : 20161117 20161117142343 ACCESSION NUMBER: 0001072613-16-000973 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161107 FILED AS OF DATE: 20161117 DATE AS OF CHANGE: 20161117 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: LIFEWAY FOODS INC CENTRAL INDEX KEY: 0000814586 STANDARD INDUSTRIAL CLASSIFICATION: DAIRY PRODUCTS [2020] IRS NUMBER: 363442829 STATE OF INCORPORATION: IL FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 6431 W OAKTON CITY: MORTON GROVE STATE: IL ZIP: 60053 BUSINESS PHONE: 847-967-1010 MAIL ADDRESS: STREET 1: 6431 W OAKTON CITY: MORTON GROVE STATE: IL ZIP: 60053 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hass Douglas CENTRAL INDEX KEY: 0001690109 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-17363 FILM NUMBER: 162004700 MAIL ADDRESS: STREET 1: 6431 W. OAKTON STREET CITY: MORTON GROVE STATE: IL ZIP: 60053 3 1 hass_form3.xml OWNERSHIP DOCUMENT X0206 3 2016-11-07 0 0000814586 LIFEWAY FOODS INC LWAY 0001690109 Hass Douglas C/O LIFEWAY FOODS, INC. 6431 W. OAKTON STREET MORTON GROVE IL 60053 0 1 0 0 Gen Counsel & Asst Corp Sec. Common Stock 1237 D Stock option (Right to buy) 9.57 2026-07-01 Common Stock 150 D Of such options, 50 will vest on July 1, 2017, 50 will vest on July 1, 2018, and 50 will vest on July 1, 2019. /s/ Douglas A. Hass 2016-11-17