0000849146-18-000028.txt : 20180206
0000849146-18-000028.hdr.sgml : 20180206
20180206163612
ACCESSION NUMBER: 0000849146-18-000028
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180202
FILED AS OF DATE: 20180206
DATE AS OF CHANGE: 20180206
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Lewis Darwin
CENTRAL INDEX KEY: 0001698767
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35647
FILM NUMBER: 18578050
MAIL ADDRESS:
STREET 1: 9785 S. MONROE STREET, SUITE 300
CITY: SANDY
STATE: UT
ZIP: 84070
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
4
1
wf-form4_151795295804569.xml
FORM 4
X0306
4
2018-02-02
0
0000849146
Lifevantage Corp
LFVN
0001698767
Lewis Darwin
9785 SOUTH MONROE STREET, SUITE 300
SANDY
UT
84070
1
0
0
0
Common Stock
2018-02-02
4
A
0
31914
0
A
35414
D
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 initial election as a director at the annual meeting of shareholders held on February 16, 2017, through the one year anniversary of his initial election as a director, and will be fully vested on February 16, 2018 subject to his continued service as a director through such date.
/s/ Darwin Lewis
2018-02-06