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