0000849146-23-000056.txt : 20230512 0000849146-23-000056.hdr.sgml : 20230512 20230512161156 ACCESSION NUMBER: 0000849146-23-000056 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230510 FILED AS OF DATE: 20230512 DATE AS OF CHANGE: 20230512 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: 23915789 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: 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_168392229927656.xml FORM 4 X0407 4 2023-05-10 0 0000849146 Lifevantage Corp LFVN 0001436020 Mauro Garry Paul 3300 TRIUMPH BLVD, SUITE 700 LEHI UT 84043 1 0 0 0 0 Common Stock 2023-05-10 4 P 0 3650 4.0799 A 63614 D Common Stock 2023-05-12 4 P 0 150 4.2074 A 63764 D Common Stock 2023-05-10 4 P 0 170 4.0799 A 25170 I By The Francesco A. Mauro Trust of 2021 Common Stock 2023-05-10 4 P 0 170 4.0799 A 25170 I By The Andrew H. Mauro Trust of 2021 Common Stock 2023-05-10 4 P 0 170 4.0799 A 25170 I By The Dominic C. Mauro Trust of 2021 Common Stock 2023-05-10 4 P 0 170 4.0799 A 25170 I By The David W.B. Mauro Trust of 2021 Common Stock 2023-05-10 4 P 0 170 4.0799 A 25170 I By The Alexandra P. Mauro Trust of 2021 Alissa Neufeld, Power of Attorney for Garry P. Mauro 2023-05-12