0000849146-15-000044.txt : 20150305
0000849146-15-000044.hdr.sgml : 20150305
20150305135253
ACCESSION NUMBER: 0000849146-15-000044
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150303
FILED AS OF DATE: 20150305
DATE AS OF CHANGE: 20150305
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: OKUMOTO RICHARD Y
CENTRAL INDEX KEY: 0001226754
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35647
FILM NUMBER: 15676813
4
1
wf-form4_142558156359971.xml
FORM 4
X0306
4
2015-03-03
0
0000849146
Lifevantage Corp
LFVN
0001226754
OKUMOTO RICHARD Y
9785 SOUTH MONROE STREET, SUITE 300
SANDY
UT
84070
1
0
0
0
Common Stock
2015-03-03
4
D
0
25000
0
D
175000
D
These shares were acquired pursuant to a restricted stock award granted on November 19, 2014, which was cancelled in its entirety prior to vesting of the shares with the Reporting Person's consent on March 3, 2015. No consideration was paid to the Reporting Person for such cancellation.
/s/ Rob Cutler, Attorney-in-Fact
2015-03-05