0000849146-18-000101.txt : 20181116
0000849146-18-000101.hdr.sgml : 20181116
20181116172129
ACCESSION NUMBER: 0000849146-18-000101
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181115
FILED AS OF DATE: 20181116
DATE AS OF CHANGE: 20181116
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: 181190693
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: 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_154240687250651.xml
FORM 4
X0306
4
2018-11-15
0
0000849146
Lifevantage Corp
LFVN
0001698767
Lewis Darwin
9785 SOUTH MONROE STREET, SUITE 400
SANDY
UT
84070
1
0
0
0
Common Stock
2018-11-15
4
A
0
6614
11.58
A
42028
D
These shares were granted to the reporting person pursuant to the issuer's outside director compensation program and will vest in a single installment on November 15, 2019, subject to continued service through such date.
/s/ Darwin Lewis
2018-11-16