0000849146-15-000127.txt : 20151201 0000849146-15-000127.hdr.sgml : 20151201 20151201110531 ACCESSION NUMBER: 0000849146-15-000127 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20151130 FILED AS OF DATE: 20151201 DATE AS OF CHANGE: 20151201 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: Jensen Darren Jay CENTRAL INDEX KEY: 0001642848 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35647 FILM NUMBER: 151261557 MAIL ADDRESS: STREET 1: C/O LIFEVANTAGE CORPORATION STREET 2: 9785 SOUTH MONROE ST. SUITE 300 CITY: SANDY STATE: UT ZIP: 84070 4 1 wf-form4_144898592084525.xml FORM 4 X0306 4 2015-11-30 0 0000849146 Lifevantage Corp LFVN 0001642848 Jensen Darren Jay 9785 SOUTH MONROE STREET, SUITE 300 SANDY UT 84070 0 1 0 0 Chief Executive Officer Common Stock 2015-11-30 4 P 0 600 8.48 A 143458 D /s/ Darren Jay Jensen 2015-11-30