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