0001181431-12-009615.txt : 20120216
0001181431-12-009615.hdr.sgml : 20120216
20120216182859
ACCESSION NUMBER: 0001181431-12-009615
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120203
FILED AS OF DATE: 20120216
DATE AS OF CHANGE: 20120216
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Brown David Whitney
CENTRAL INDEX KEY: 0001425341
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-30489
FILM NUMBER: 12620560
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
rrd334777.xml
BROWN FORM 4 2-16-2012
X0304
4
2012-02-03
0
0000849146
Lifevantage Corp
LFVN
0001425341
Brown David Whitney
9815 S. MONROE STREET
SUITE 100
SANDY
UT
84070
1
1
0
0
President, LifeVantage Network
Common Stock
2012-02-03
4
M
0
50000
0.50
A
50000
D
Common Stock
2012-02-09
4
M
0
50000
0.50
A
100000
D
Common Stock
2012-02-09
4
F
0
13369
1.87
D
86631
D
Warrant (Right to Buy)
0.50
2012-02-03
4
M
0
50000
0
D
2009-04-07
2012-04-07
Common Stock
50000
50000
D
Warrant (Right to Buy)
0.50
2012-02-09
4
M
0
50000
0
D
2009-04-07
2012-04-07
Common Stock
50000
0
D
This cashless warrant exercise was effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person in December 2011
/s/ Rob Cutler, Attorney in-fact for David Whitney Brown
2012-02-16