0001181431-12-009614.txt : 20120216 0001181431-12-009614.hdr.sgml : 20120216 20120216182824 ACCESSION NUMBER: 0001181431-12-009614 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120209 FILED AS OF DATE: 20120216 DATE AS OF CHANGE: 20120216 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: 000-30489 FILM NUMBER: 12620555 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: 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 rrd334841.xml MAURO FORM 4 2-16-12 X0304 4 2012-02-09 0 0000849146 Lifevantage Corp LFVN 0001436020 Mauro Garry Paul 9815 S. MONROE STREET SUITE 100 SANDY UT 84070 1 0 0 0 Common Stock 2012-02-09 4 M 0 150000 0.50 A 303796 D Common Stock 2012-02-09 4 F 0 40107 1.87 D 263689 D Common Stock 170 I By Son Common Stock 374 I By Son Common Stock 177 I By Son Common Stock 374 I By Daughter Common Stock 170 I By Son Warrant (Right to Buy) 0.50 2012-02-09 4 M 0 150000 0 D 2009-04-07 2012-04-07 Common Stock 150000 0 D This cashless warrant exercise was effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person on December 7, 2011 /s/ Rob Cutler, Attorney in-fact for Garry Paul Mauro 2012-02-16