0001181431-12-033650.txt : 20120531 0001181431-12-033650.hdr.sgml : 20120531 20120531154543 ACCESSION NUMBER: 0001181431-12-033650 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120529 FILED AS OF DATE: 20120531 DATE AS OF CHANGE: 20120531 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Urban Robert M. CENTRAL INDEX KEY: 0001551128 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-30489 FILM NUMBER: 12880501 MAIL ADDRESS: STREET 1: 9815 S. MONROE STREET, 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 rrd347119.xml FORM 4 X0305 4 2012-05-29 0 0000849146 Lifevantage Corp LFVN 0001551128 Urban Robert M. 9815 S. MONROE STREET SUITE 100 SANDY UT 84070 0 1 0 0 Chief Operating Officer Common Stock 2012-05-29 4 A 0 14500 0 A 16100 D Stock Option (Right to Buy) 3.19 2012-05-29 4 A 0 150000 0 D 2022-05-28 Common Stock 150000 150000 D These shares were acquired pursuant to a restricted stock award granted on May 29, 2012, which vests in four equal annual installments on each of the first four anniversaries of the grant date, subject to continued service with the company. This stock option was granted on May 29, 2012 and vests as follows: (i) 1/4 of the shares subject to the option vests on the first anniversary of the grant date and (ii) an additional 1/48 of the shares subject to the option vests each of the 36 months following the first anniversary of the grant date, subject to continued service with the company. /s/ Carrie McQueen, Attorney-in-Fact for Robert Urban 2012-05-31