0000849146-16-000184.txt : 20160825
0000849146-16-000184.hdr.sgml : 20160825
20160825164044
ACCESSION NUMBER: 0000849146-16-000184
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160824
FILED AS OF DATE: 20160825
DATE AS OF CHANGE: 20160825
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: 161852019
MAIL ADDRESS:
STREET 1: 662 HAMPTON CT
CITY: ALPINE
STATE: UT
ZIP: 84004
4
1
wf-form4_147215763230677.xml
FORM 4
X0306
4
2016-08-24
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
2016-08-24
4
F
0
2478
13.88
D
15665
D
These shares were withheld to satisfy tax withholding obligations in connection with the partial vesting of a restricted stock award granted on August 24, 2015.
/s/ Mark Jaggi
2016-08-25