0000849146-20-000181.txt : 20201202 0000849146-20-000181.hdr.sgml : 20201202 20201202160630 ACCESSION NUMBER: 0000849146-20-000181 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201201 FILED AS OF DATE: 20201202 DATE AS OF CHANGE: 20201202 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: 201363828 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_160694317633574.xml FORM 4 X0306 4 2020-12-01 0 0000849146 Lifevantage Corp LFVN 0001436020 Mauro Garry Paul 9785 SOUTH MONROE STREET, SUITE 400 SANDY UT 84070 1 0 0 0 Common Stock 2020-12-01 4 M 0 17143 5.60 A 159227 D Common Stock 2020-12-01 4 M 0 14286 9.31 A 173513 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.) Stock Option (Right to Buy) 5.6 2020-12-01 4 M 0 17143 0 D 2011-01-20 2021-01-20 Common Stock 17143.0 0 D Stock Option (Right to Buy) 9.31 2020-12-01 4 M 0 14286 0 D 2012-01-10 2022-01-10 Common Stock 14286.0 0 D Garry P. Mauro 2020-12-02