0000849146-19-000049.txt : 20190507 0000849146-19-000049.hdr.sgml : 20190507 20190507172134 ACCESSION NUMBER: 0000849146-19-000049 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190504 FILED AS OF DATE: 20190507 DATE AS OF CHANGE: 20190507 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Brockovich Erin CENTRAL INDEX KEY: 0001324073 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35647 FILM NUMBER: 19804230 MAIL ADDRESS: STREET 1: 5125 LANKERSHIM BOULEVARD CITY: NORTH HOLLYWOOD STATE: CA ZIP: 91601 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_155726407955219.xml FORM 4 X0306 4 2019-05-04 0 0000849146 Lifevantage Corp LFVN 0001324073 Brockovich Erin 9785 SOUTH MONROE STREET SUITE 400 SANDY UT 84070 1 0 0 0 Common Stock 2019-05-04 4 A 0 3502 11.69 A 3502 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 her service on the Board of Directors from the date of her initial appointment as a director (May 4, 2019) through the date of the next annual meeting of shareholders, which is expected to be held in November 2019. Subject to her continued service as a director, the award will vest in full on the one year anniversary of her initial appointment as a director (May 4, 2020). /s/ Erin Brockovich 2019-05-07