0000849146-18-000036.txt : 20180206
0000849146-18-000036.hdr.sgml : 20180206
20180206163850
ACCESSION NUMBER: 0000849146-18-000036
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: Wach Charles J.
CENTRAL INDEX KEY: 0001701034
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35647
FILM NUMBER: 18578103
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_151795311439191.xml
FORM 4
X0306
4
2018-02-02
0
0000849146
Lifevantage Corp
LFVN
0001701034
Wach Charles J.
9785 SOUTH MONROE STREET, SUITE 300
SANDY
UT
84070
0
1
0
0
Chief Operating Officer
Stock Option (Right to Buy)
4.44
2018-02-02
4
A
0
45000
0
A
2028-02-01
Common Stock
45000.0
45000
D
Phantom Shares
2018-02-02
4
A
0
19750
0
A
Common Stock
19750.0
19750
D
This stock option will vest as follows: (i) 1/3 of the option vests on January 1, 2019 and (ii) an additional 1/12 of the option vests each quarter for each of the 24 months following January 1, 2019, subject to continued service with the company.
Each Phantom Share represents the right to be paid in cash an amount equal to any increase in value of a single share of LFVN common stock, measured from December 31, 2017 to December 31, 2018.
Phantom Shares will be settled following certification of achievement of the price-based condition, which will occur no later than March 15, 2019.
/s/ Charles J. Wach
2018-02-06