0001181431-12-006599.txt : 20120207 0001181431-12-006599.hdr.sgml : 20120207 20120207191208 ACCESSION NUMBER: 0001181431-12-006599 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120207 FILED AS OF DATE: 20120207 DATE AS OF CHANGE: 20120207 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: McQueen Carrie E CENTRAL INDEX KEY: 0001469779 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-30489 FILM NUMBER: 12579373 MAIL ADDRESS: STREET 1: 11545 W. BERNARDO COURT STREET 2: SUITE 301 CITY: SAN DIEGO STATE: CA ZIP: 92127 FORMER NAME: FORMER CONFORMED NAME: Carlander Carrie E DATE OF NAME CHANGE: 20090806 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 rrd333042.xml FORM 4- MCQUEEN 2-3-12 X0304 4 2012-02-07 0 0000849146 Lifevantage Corp LFVN 0001469779 McQueen Carrie E 9815 S. MONROE STREET SANDY UT 84070 0 1 0 0 Chief Financial Officer Stock Option (Right to Buy) 1.50 2012-02-03 4 A 0 150000 0 A 2022-02-02 Common Stock 150000 150000 D ) This stock option will vest as follows: (i) 1/4 of the option vests on February 3, 2013 and (ii) an additional 1/48 of the option vests per month for each of the 36 months following February 3, 2013, subject to continued service with the company. /s/ Carrie E. McQueen 2012-02-07