0000849146-16-000162.txt : 20160330
0000849146-16-000162.hdr.sgml : 20160330
20160330154943
ACCESSION NUMBER: 0000849146-16-000162
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160328
FILED AS OF DATE: 20160330
DATE AS OF CHANGE: 20160330
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: 161539421
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_145936737193009.xml
FORM 4
X0306
4
2016-03-28
0
0000849146
Lifevantage Corp
LFVN
0001649432
Rose Justin
9785 SOUTH MONROE STREET, SUITE 300
SANDY
UT
84070
0
1
0
0
Chief Sales Officer
Performance Stock Units
2016-03-28
4
D
0
15333
0
D
2016-12-31
Common Stock
15333.0
0
D
Performance Stock Units
2016-03-28
4
D
0
15333
0
D
2017-12-31
Common Stock
15333.0
0
D
Performance Stock Units
2016-03-28
4
D
0
15334
0
D
2018-12-31
Common Stock
15334.0
0
D
Performance Stock Units
2016-03-28
4
A
0
46000
0
A
2018-12-31
Common Stock
46000.0
46000
D
The cancelled Performance Stock Units were subject to three one-year performance periods: 1/1/2016 through 12/31/2016, 1/1/2017 through 12/31/2017, and 1/1/2018 through 12/31/2018, in each case, subject to earlier expiration of the relevant performance period upon a change in control of the issuer (each, a "One Year Performance Period"). The actual number of shares distributed was to have been based on the issuer's total stockholder return (TSR) performance during the relevant One Year Performance Period. Subject generally to the reporting person's continued service with the issuer, the cancelled Performance Stock Units represented a contingent right for the reporting person to receive, within 30 days after the end of the relevant One Year Performance Period, a distribution of common shares of the issuer equal to 0% to 200% of the target number of Performance Stock Units.
The reported transactions involved an amendment to the outstanding Performance Stock Units, resulting in the deemed cancellation of the "old" Performance Stock Units that were granted effective January 4, 2016, and the grant of replacement Performance Stock Units.
The replacement Performance Stock Units ("PSUs") are subject to a three-year performance period of 1/1/2016 through 12/31/2018, subject to earlier expiration upon a change in control of the issuer ("Performance Period"). Subject generally to the reporting person's continued service with the issuer, each replacement PSU represents a contingent right for such person to receive, within 30 days after the end of the Performance Period, a distribution of common shares of the issuer equal to 0% to 200% of the reported target number of PSUs. The actual number of shares distributed will be based on the issuer's TSR performance during the Performance Period. Vesting for 50% of the target PSUs is based upon the issuer's absolute TSR for the Performance Period as compared to a matrix of fixed numeric values and the vesting for the other 50% of the target PSUs is based upon a relative comparison of the issuer's TSR to the Vanguard Russell 2000 exchange traded fund TSR for such period.
/s/ Justin Rose
2016-03-30