0000849146-17-000041.txt : 20170221 0000849146-17-000041.hdr.sgml : 20170220 20170221171443 ACCESSION NUMBER: 0000849146-17-000041 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170216 FILED AS OF DATE: 20170221 DATE AS OF CHANGE: 20170221 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: Manovich Dave CENTRAL INDEX KEY: 0001539712 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35647 FILM NUMBER: 17625987 MAIL ADDRESS: STREET 1: C/O LIFEVANTAGE CORPORATION STREET 2: 9815 SOUTH MONROE ST., SUITE 100 CITY: SANDY STATE: UT ZIP: 84070 4 1 wf-form4_148771526969839.xml FORM 4 X0306 4 2017-02-16 1 0000849146 Lifevantage Corp LFVN 0001539712 Manovich Dave 9785 SOUTH MONROE STREET, SUITE 300 SANDY UT 84070 0 0 0 1 Former Director Common Stock 2017-02-16 4 A 0 7708 0 A 23423 D Common Stock 43649 D Common Stock 34286 I By Spouse Common Stock 5715 I Beneficiary of 401(k) Account These shares were granted to the reporting person pursuant to the issuer's outside director compensation program. The award compensates the reporting person for his service on the Board of Directors from the date of his re-election as a director at the annual meeting of shareholders held on October 15, 2015, through the following annual meeting of shareholders, which was held on February 16, 2017, and as such was fully vested at grant. Joint with spouse /s/ Dave Manovich 2017-02-21