0000849146-20-000021.txt : 20200110
0000849146-20-000021.hdr.sgml : 20200110
20200110143549
ACCESSION NUMBER: 0000849146-20-000021
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200108
FILED AS OF DATE: 20200110
DATE AS OF CHANGE: 20200110
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Rose Justin
CENTRAL INDEX KEY: 0001649432
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35647
FILM NUMBER: 20520653
MAIL ADDRESS:
STREET 1: C/O LIFEVANTAGE CORPORATION
STREET 2: 9785 S. 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_157868493160382.xml
FORM 4
X0306
4
2020-01-08
0
0000849146
Lifevantage Corp
LFVN
0001649432
Rose Justin
9785 SOUTH MONROE STREET, SUITE 400
SANDY
UT
84070
0
1
0
0
Chief Sales Officer
Common Stock
2020-01-08
4
F
0
7304
15.54
D
139192
D
These shares were withheld to satisfy tax withholding obligations in connection with the vesting of a stock unit award granted to the reporting person on January 8, 2019.
/s/ Justin Rose
2020-01-10