0000849146-19-000108.txt : 20191209
0000849146-19-000108.hdr.sgml : 20191209
20191209171049
ACCESSION NUMBER: 0000849146-19-000108
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191205
FILED AS OF DATE: 20191209
DATE AS OF CHANGE: 20191209
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Mauro Garry Paul
CENTRAL INDEX KEY: 0001436020
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35647
FILM NUMBER: 191275937
MAIL ADDRESS:
STREET 1: 6400 S. FIDDLER'S GREEN CIRCLE
STREET 2: SUITE 1970
CITY: GREENWOOD VILLAGE
STATE: X1
ZIP: 80111
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_157592943251246.xml
FORM 4
X0306
4
2019-12-05
0
0000849146
Lifevantage Corp
LFVN
0001436020
Mauro Garry Paul
9785 SOUTH MONROE STREET, SUITE 400
SANDY
UT
84070
1
0
0
0
Common Stock
2019-12-05
4
A
0
5051
15.20
A
135065
D
Common Stock
225
I
By Spouse
Common Stock
196
I
By Son (F.M.)
Common Stock
195
I
By Son (A.M.)
Common Stock
195
I
By Son (D.M.)
Common Stock
54
I
By Daughter (A.P.M.)
Common Stock
54
I
By Son (D.W.M.)
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 December 5, 2020, subject to continued service through such date.
Garry P. Mauro
2019-12-09