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