0000849146-17-000024.txt : 20170214 0000849146-17-000024.hdr.sgml : 20170214 20170214174838 ACCESSION NUMBER: 0000849146-17-000024 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170213 FILED AS OF DATE: 20170214 DATE AS OF CHANGE: 20170214 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: 17611354 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_148711250212433.xml FORM 4 X0306 4 2017-02-13 0 0000849146 Lifevantage Corp LFVN 0001649432 Rose Justin 9785 SOUTH MONROE STREET, SUITE 300 SANDY UT 84070 0 1 0 0 Chief Sales Officer Common Stock 2017-02-13 4 P 0 1500 6.75 A 16794 D /s/ Justin Rose 2017-02-14