0000849146-16-000163.txt : 20160330 0000849146-16-000163.hdr.sgml : 20160330 20160330155027 ACCESSION NUMBER: 0000849146-16-000163 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: Urban Robert M. CENTRAL INDEX KEY: 0001551128 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35647 FILM NUMBER: 161539430 MAIL ADDRESS: STREET 1: 9815 S. MONROE STREET, SUITE 100 CITY: SANDY STATE: UT ZIP: 84070 4 1 wf-form4_145936741490013.xml FORM 4 X0306 4 2016-03-28 0 0000849146 Lifevantage Corp LFVN 0001551128 Urban Robert M. 9785 SOUTH MONROE STREET, SUITE 300 SANDY UT 84070 0 1 0 0 Chief Operating 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/ Robert M. Urban 2016-03-30