0000849146-23-000054.txt : 20230511
0000849146-23-000054.hdr.sgml : 20230511
20230511071141
ACCESSION NUMBER: 0000849146-23-000054
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230509
FILED AS OF DATE: 20230511
DATE AS OF CHANGE: 20230511
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Lewis Darwin
CENTRAL INDEX KEY: 0001698767
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35647
FILM NUMBER: 23908785
MAIL ADDRESS:
STREET 1: 9785 S. MONROE STREET, SUITE 300
CITY: SANDY
STATE: UT
ZIP: 84070
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_168380348896731.xml
FORM 4
X0407
4
2023-05-09
0
0000849146
Lifevantage Corp
LFVN
0001698767
Lewis Darwin
3300 TRIUMPH BLVD, SUITE 700
LEHI
UT
84043
1
0
0
0
0
Common Stock
2023-05-09
4
P
0
1000
3.8784
A
85284
D
Alissa Neufeld, Power of Attorney for Darwin Lewis
2023-05-11