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