0001181431-11-060471.txt : 20111214 0001181431-11-060471.hdr.sgml : 20111214 20111214172940 ACCESSION NUMBER: 0001181431-11-060471 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111213 FILED AS OF DATE: 20111214 DATE AS OF CHANGE: 20111214 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Robinson Douglas C. CENTRAL INDEX KEY: 0001481886 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-30489 FILM NUMBER: 111261828 MAIL ADDRESS: STREET 1: C/O LIFEVANTAGE CORPORATION STREET 2: 11545 W. BERNARDO CT., SUITE 301 CITY: SAN DIEGO STATE: CA ZIP: 92127 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Lifevantage Corp CENTRAL INDEX KEY: 0000849146 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 841097796 STATE OF INCORPORATION: CO FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: 10813 S. RIVER FRONT PARKWAY STREET 2: STE. 500 CITY: SOUTH JORDAN STATE: UT ZIP: 84095 BUSINESS PHONE: 858-312-8000 MAIL ADDRESS: STREET 1: 10813 S. RIVER FRONT PARKWAY STREET 2: STE. 500 CITY: SOUTH JORDAN STATE: UT ZIP: 84095 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 rrd328200.xml FORM 4- ROBINSON 12-13-11 X0304 4 2011-12-13 0 0000849146 Lifevantage Corp LFVN 0001481886 Robinson Douglas C. 11545 W. BERNARDO COURT, SUITE 301 SAN DIEGO CA 92127 1 1 0 0 President & CEO Common Stock 2011-12-13 4 M 0 120000 0.36 A 120000 D Common Stock 2011-12-13 4 S 0 120000 1.4300 D 0 D Stock Option (Right to Buy) 0.36 2011-12-13 4 M 0 120000 0 D 2020-01-25 Common Stock 120000 0 D Exercise of stock option granted January 25, 2010 which vested and became exercisable in 12 equal monthly installments beginning on February 25, 2010. Douglas C Robinson 2011-12-14