0000849146-17-000029.txt : 20170214 0000849146-17-000029.hdr.sgml : 20170214 20170214191932 ACCESSION NUMBER: 0000849146-17-000029 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: Mauro Garry Paul CENTRAL INDEX KEY: 0001436020 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35647 FILM NUMBER: 17612271 MAIL ADDRESS: STREET 1: 6400 S. FIDDLER'S GREEN CIRCLE STREET 2: SUITE 1970 CITY: GREENWOOD VILLAGE STATE: X1 ZIP: 80111 4 1 wf-form4_148711795830636.xml FORM 4 X0306 4 2017-02-13 0 0000849146 Lifevantage Corp LFVN 0001436020 Mauro Garry Paul 9785 SOUTH MONROE STREET, SUITE 300 SANDY UT 84070 1 0 0 0 Common Stock 2017-02-13 4 P 0 1700 6.71 A 46513 D Common Stock 2017-02-13 4 P 0 225 6.75 A 225 I By Spouse Common Stock 2017-02-13 4 P 0 170 6.75 A 196 I By Son (F.M.) Common Stock 2017-02-13 4 P 0 170 6.75 A 195 I By Son (D.M.) Common Stock 2017-02-13 4 P 0 170 6.75 A 195 I By Son (A.M.) Common Stock 54 I By Son (D.W.M.) Common Stock 54 I By Daughter (A.P.M.) Garry P. Mauro 2017-02-14