0000849146-18-000060.txt : 20180521 0000849146-18-000060.hdr.sgml : 20180521 20180521134036 ACCESSION NUMBER: 0000849146-18-000060 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180518 FILED AS OF DATE: 20180521 DATE AS OF CHANGE: 20180521 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jensen Darren Jay CENTRAL INDEX KEY: 0001642848 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35647 FILM NUMBER: 18849080 MAIL ADDRESS: STREET 1: C/O LIFEVANTAGE CORPORATION STREET 2: 9785 SOUTH MONROE ST. 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: DE 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_152692442218845.xml FORM 4 X0306 4 2018-05-18 0 0000849146 Lifevantage Corp LFVN 0001642848 Jensen Darren Jay 9785 SOUTH MONROE STREET, SUITE 400 SANDY UT 84070 1 1 0 0 Chief Executive Officer Common Stock 2018-05-18 4 F 0 41858 4.84 D 109500 D /s/ Darren Jay Jensen 2018-05-21