0000849146-15-000090.txt : 20150825 0000849146-15-000090.hdr.sgml : 20150825 20150825170128 ACCESSION NUMBER: 0000849146-15-000090 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150824 FILED AS OF DATE: 20150825 DATE AS OF CHANGE: 20150825 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: Jaggi Mark R. CENTRAL INDEX KEY: 0001619265 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35647 FILM NUMBER: 151073716 MAIL ADDRESS: STREET 1: 662 HAMPTON CT CITY: ALPINE STATE: UT ZIP: 84004 4 1 wf-form4_144053647827727.xml FORM 4 X0306 4 2015-08-24 0 0000849146 Lifevantage Corp LFVN 0001619265 Jaggi Mark R. 9785 SOUTH MONROE STREET, SUITE 300 SANDY UT 84070 0 1 0 0 Chief Financial Officer Common Stock 2015-08-24 4 A 0 120000 0 A 120000 D These shares were acquired pursuant to a restricted stock award granted August 24, 2015, which vests in three equal annual installments one each of August 24, 2016, August 24, 2017, and August 24, 2018, subject to continued service with the Company. /s/ Mark Jaggi 2015-08-25