0000849146-17-000076.txt : 20170329 0000849146-17-000076.hdr.sgml : 20170329 20170329163446 ACCESSION NUMBER: 0000849146-17-000076 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170328 FILED AS OF DATE: 20170329 DATE AS OF CHANGE: 20170329 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: Washington Beatryx CENTRAL INDEX KEY: 0001698608 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35647 FILM NUMBER: 17722644 MAIL ADDRESS: STREET 1: 9785 S. MONROE STREET, SUITE 300 CITY: SANDY STATE: UT ZIP: 84070 4 1 wf-form4_149081967192569.xml FORM 4 X0306 4 2017-03-28 0 0000849146 Lifevantage Corp LFVN 0001698608 Washington Beatryx 9785 S. MONROE STREET, SUITE 300 SANDY UT 84070 0 1 0 0 Senior VP and General Counsel Performance Stock Units 2017-03-28 4 A 0 46700 0 A 2019-12-31 Common Stock 46700.0 46700 D The Performance Stock Units ("PSUs") are subject to a three-year performance period of 1/1/2017 through 12/31/2019, subject to earlier expiration upon a change in control of the issuer ("Performance Period"). Subject generally to the reporting person's continued service with the issuer, each PSU represents a contingent right for such person to receive, within 30 days after the end of the Performance Period, a distribution of common shares of the issuer equal to 0% to 200% of the reported target number of PSUs. The actual number of shares distributed will be based on the issuer's total stockholder return (TSR) performance during the Performance Period. Vesting for 50% of the target PSUs is based upon the issuer's absolute TSR for the Performance Period as compared to a matrix of fixed numeric values and the vesting for the other 50% of the target PSUs is based upon a relative comparison of the issuer's TSR to the Vanguard Russell 2000 exchange traded fund TSR for such period. /s/ Beatryx Washington 2017-03-29