-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, LYQnNguJH5mtPQV2gyUZCbc0TKv68vSm2iuJwwEhe1RvtF7Tnx8UDhl1WCJ2jIqH N+aZ9skKyv5kf1A1oi6bfw== 0001209191-10-006712.txt : 20100203 0001209191-10-006712.hdr.sgml : 20100203 20100203185300 ACCESSION NUMBER: 0001209191-10-006712 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20091130 FILED AS OF DATE: 20100203 DATE AS OF CHANGE: 20100203 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: 10571971 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: 11545 WEST BERNARDO COURT STREET 2: SUITE 301 CITY: SAN DIEGO STATE: CA ZIP: 92127 BUSINESS PHONE: 858-312-8000 MAIL ADDRESS: STREET 1: 11545 WEST BERNARDO COURT STREET 2: SUITE 301 CITY: SAN DIEGO STATE: CA ZIP: 92127 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 c95271_4x0.xml MAIN DOCUMENT DESCRIPTION X0303 4 2009-11-30 0000849146 Lifevantage Corp LFVN 0001436020 Mauro Garry Paul 11545 W. BERNARDO CT. SUITE 301 SAN DIEGO CA 92127 1 0 0 0 Stock Option (Right to Buy) 0.25 2009-11-30 4 A 0 120000 0 A 2019-11-30 Common Stock 120000 120000 D This option vests and becomes exercisable in full upon the earlier of (i) the achievement of certain performance criteria, or (ii) November 30, 2011. /s/ Garry P. Mauro 2010-02-03 -----END PRIVACY-ENHANCED MESSAGE-----