0000849146-19-000112.txt : 20191209 0000849146-19-000112.hdr.sgml : 20191209 20191209172532 ACCESSION NUMBER: 0000849146-19-000112 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: Jensen Darren Jay CENTRAL INDEX KEY: 0001642848 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35647 FILM NUMBER: 191276076 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_157593031448020.xml FORM 4 X0306 4 2019-12-05 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 2019-12-05 4 A 0 26937 0 A 438407 D Performance Restricted Stock Units 2019-12-05 5 A 0 E 26937 0 A Common Stock 26937.0 26937 D This reflects a stock unit award, in which each stock unit represents a right to receive one share of issuer common stock, which award will vest, subject to the reporting person's continued service with the issuer, as follows: (i) 5/12ths of the total number of units will vest on the first anniversary of the grant date and (ii) an additional 1/12 of the total number of units will vest as of the first day of each calendar quarter thereafter. Each PRSU represents a right to receive one share of issuer common stock, with the total number of units reflecting the number that are eligible to be earned at target-level performance achievement. Upon achievement of the maximum level of the applicable performance criteria, the reporting person may become eligible to earn 200% of the target number of units The PRSUs will vest only to the extent the specified financial performance criteria are achieved and subject to the reporting person's continued service with the issuer, as follows: (i) 5/12ths of the earned award will vest on the first anniversary of the grant date and (ii) an additional 1/12 of the earned award will vest as of the first day of each calendar quarter thereafter. /s/ Darren Jay Jensen 2019-12-09