0000849146-22-000088.txt : 20221115
0000849146-22-000088.hdr.sgml : 20221115
20221115160747
ACCESSION NUMBER: 0000849146-22-000088
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20221110
FILED AS OF DATE: 20221115
DATE AS OF CHANGE: 20221115
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Brockovich Erin
CENTRAL INDEX KEY: 0001324073
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35647
FILM NUMBER: 221391232
MAIL ADDRESS:
STREET 1: 5125 LANKERSHIM BOULEVARD
CITY: NORTH HOLLYWOOD
STATE: CA
ZIP: 91601
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_166854644277313.xml
FORM 4
X0306
4
2022-11-10
0
0000849146
Lifevantage Corp
LFVN
0001324073
Brockovich Erin
3300 TRIUMPH BLVD, SUITE 700
LEHI
UT
84043
1
0
0
0
Common Stock
2022-11-10
4
A
0
19430
3.85
A
45758
D
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 10, 2023, subject to continued service through such date.
Alissa Nuefeld, Power of Attorney for Erin Brockovich
2022-11-15