0000849146-13-000055.txt : 20131114 0000849146-13-000055.hdr.sgml : 20131114 20131114163204 ACCESSION NUMBER: 0000849146-13-000055 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20131113 FILED AS OF DATE: 20131114 DATE AS OF CHANGE: 20131114 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Lifevantage Corp CENTRAL INDEX KEY: 0000849146 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 841097796 STATE OF INCORPORATION: CO FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: 9815 S. MONROE STREET STREET 2: SUITE 100 CITY: SANDY STATE: UT ZIP: 84070 BUSINESS PHONE: 801-432-9000 MAIL ADDRESS: STREET 1: 9815 S. MONROE STREET STREET 2: SUITE 100 CITY: SANDY STATE: UT ZIP: 84070 FORMER COMPANY: FORMER CONFORMED NAME: LIFELINE THERAPEUTICS, INC. DATE OF NAME CHANGE: 20041019 FORMER COMPANY: FORMER CONFORMED NAME: YAAK RIVER RESOURCES INC DATE OF NAME CHANGE: 19920703 FORMER COMPANY: FORMER CONFORMED NAME: ANDRAPLEX CORP DATE OF NAME CHANGE: 19920406 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Manovich Dave CENTRAL INDEX KEY: 0001539712 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35647 FILM NUMBER: 131220671 MAIL ADDRESS: STREET 1: C/O LIFEVANTAGE CORPORATION STREET 2: 9815 SOUTH MONROE ST., SUITE 100 CITY: SANDY STATE: UT ZIP: 84070 4 1 wf-form4_138446467784871.xml FORM 4 X0306 4 2013-11-13 0 0000849146 Lifevantage Corp LFVN 0001539712 Manovich Dave 9815 S. MONROE STREET, SUITE 100 SANDY UT 84070 1 0 0 0 Common Stock 2013-11-13 4 A 0 25000 0 A 60000 D Common Stock 305537 D Common Stock 240000 I By Spouse Common Stock 40000 I Beneficiary of 401(k) Account These shares were acquired pursuant to a restricted stock award granted November 13, 2013, which vests in full in a single vesting increment on the date of the Company's next annual meeting of shareholders, subject to continued service with the Company. Joint with spouse /s/ Rob Cutler, Attorney-in-Fact 2013-11-13