0000849146-14-000092.txt : 20141119 0000849146-14-000092.hdr.sgml : 20141119 20141119162902 ACCESSION NUMBER: 0000849146-14-000092 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20141119 FILED AS OF DATE: 20141119 DATE AS OF CHANGE: 20141119 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: Mauro Garry Paul CENTRAL INDEX KEY: 0001436020 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35647 FILM NUMBER: 141235840 MAIL ADDRESS: STREET 1: 6400 S. FIDDLER'S GREEN CIRCLE STREET 2: SUITE 1970 CITY: GREENWOOD VILLAGE STATE: X1 ZIP: 80111 4 1 wf-form4_141643253266102.xml FORM 4 X0306 4 2014-11-19 0 0000849146 Lifevantage Corp LFVN 0001436020 Mauro Garry Paul 9785 SOUTH MONROE STREET, SUITE 300 SANDY UT 84070 1 0 0 0 Common Stock 2014-11-19 4 A 0 25000 0 A 338689 D Common Stock 374 I By Son (D.W.M.) Common Stock 374 I By Daughter (A.P.M.) Common Stock 177 I By Son (F.M.) Common Stock 170 I By Son (A.M.) Common Stock 170 I By Son (D.M.) These shares were acquired pursuant to a restricted stock award granted November 19, 2014, 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. /s/ Rob Cutler, Attorney-in-Fact 2014-11-19