0000849146-21-000086.txt : 20210908
0000849146-21-000086.hdr.sgml : 20210908
20210908160710
ACCESSION NUMBER: 0000849146-21-000086
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210903
FILED AS OF DATE: 20210908
DATE AS OF CHANGE: 20210908
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Fife Steven R
CENTRAL INDEX KEY: 0001408954
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35647
FILM NUMBER: 211242216
MAIL ADDRESS:
STREET 1: C/O LECG 2000 POWELL STREET, STE 600
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
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: 3300 TRIUMPH BLVD
STREET 2: SUITE 700
CITY: LEHI
STATE: UT
ZIP: 84043
BUSINESS PHONE: 801-432-9000
MAIL ADDRESS:
STREET 1: 3300 TRIUMPH BLVD
STREET 2: SUITE 700
CITY: LEHI
STATE: UT
ZIP: 84043
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_163113161200164.xml
FORM 4
X0306
4
2021-09-03
0
0000849146
Lifevantage Corp
LFVN
0001408954
Fife Steven R
3300 NORTH TRIUMPH BLVD #700
LEHI
UT
84043
1
1
0
0
President CEO and CFO
Common Stock
2021-09-03
4
F
0
3730
7.70
D
214622
D
These shares were withheld to satisfy tax withholding obligations in connection with the partial vesting of a restricted stock award granted on September 3, 2020.
/s/ Steven R. Fife
2021-09-08