0001181431-12-009612.txt : 20120216 0001181431-12-009612.hdr.sgml : 20120216 20120216182726 ACCESSION NUMBER: 0001181431-12-009612 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120214 FILED AS OF DATE: 20120216 DATE AS OF CHANGE: 20120216 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Manovich Dave CENTRAL INDEX KEY: 0001539712 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-30489 FILM NUMBER: 12620551 MAIL ADDRESS: STREET 1: C/O LIFEVANTAGE CORPORATION STREET 2: 9815 SOUTH MONROE ST., SUITE 100 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: 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 rrd334843.xml MANOVICH- FORM 4 2-16-12 X0304 4 2012-02-14 0 0000849146 Lifevantage Corp LFVN 0001539712 Manovich Dave 9815 S. MONROE STREET SANDY UT 84070 1 0 0 0 Common Stock 2012-02-14 4 M 0 120000 0.36 A 120000 I By Spouse Common Stock 2012-02-14 4 M 0 120000 0.80 A 240000 I By Spouse Common Stock 305537 D Common Stock 10000 D Common Stock 40000 I Beneficiary of 401(k) account Stock Option (Right to Buy) 0.36 2012-02-14 4 M 0 120000 0 D 2020-01-25 Common Stock 120000 0 I By Spouse Stock Option (Right to Buy) 0.80 2012-02-14 4 M 0 120000 0 D 2021-01-20 Common Stock 120000 0 I By Spouse Joint with spouse Exercise of stock option granted January 25, 2010 which vested and became exercisable in 12 equal monthly installments beginning February 25, 2010. Exercise of stock option granted January 20, 2011 which vested and became exercisable in 10 equal installments beginning on the grant date. /s/ Rob Cutler, Attorney in-fact for Dave Manovich 2012-02-16