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