0000849146-15-000078.txt : 20150729 0000849146-15-000078.hdr.sgml : 20150729 20150729131306 ACCESSION NUMBER: 0000849146-15-000078 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150727 FILED AS OF DATE: 20150729 DATE AS OF CHANGE: 20150729 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: 9785 S. MONROE STREET STREET 2: SUITE 300 CITY: SANDY STATE: UT ZIP: 84070 BUSINESS PHONE: 801-432-9000 MAIL ADDRESS: STREET 1: 9785 S. MONROE STREET STREET 2: SUITE 300 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: Rose Justin CENTRAL INDEX KEY: 0001649432 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35647 FILM NUMBER: 151012072 MAIL ADDRESS: STREET 1: C/O LIFEVANTAGE CORPORATION STREET 2: 9785 S. MONROE ST. SUITE 300 CITY: SANDY STATE: UT ZIP: 84070 4 1 wf-form4_143818997686095.xml FORM 4 X0306 4 2015-07-27 0 0000849146 Lifevantage Corp LFVN 0001649432 Rose Justin 9785 SOUTH MONROE STREET, SUITE 300 SANDY UT 84070 0 1 0 0 Chief Sales Officer Common Stock 2015-07-27 4 A 0 120000 0 A 120000 D These shares were acquired pursuant to a restricted stock award granted July 27, 2015, which vests in three equal annual installments on each of July 27, 2016, July 27, 2017, and July 27, 2018, subject to continued service with the Company. /s/ Justin Rose 2015-07-29