0000849146-20-000177.txt : 20201113 0000849146-20-000177.hdr.sgml : 20201113 20201113161132 ACCESSION NUMBER: 0000849146-20-000177 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201112 FILED AS OF DATE: 20201113 DATE AS OF CHANGE: 20201113 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: 201311606 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_160530187759936.xml FORM 4 X0306 4 2020-11-12 0 0000849146 Lifevantage Corp LFVN 0001436020 Mauro Garry Paul 9785 SOUTH MONROE STREET, SUITE 400 SANDY UT 84070 1 0 0 0 Common Stock 2020-11-12 4 A 0 6794 11.15 A 142084 D 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 November 12, 2021, subject to continued service through such date. Garry P. Mauro 2020-11-13