-----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, Oa+0ibtWSnyXu93WEe80yOSh/RcprB6eyeLGd2BYxeiM2WUzAuJae0F3Y66Y5a7O Imbb8z0dw1oRUmmJDlDH6Q== 0001209191-10-007642.txt : 20100208 0001209191-10-007642.hdr.sgml : 20100208 20100208193631 ACCESSION NUMBER: 0001209191-10-007642 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20100204 FILED AS OF DATE: 20100208 DATE AS OF CHANGE: 20100208 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lu C. Mike CENTRAL INDEX KEY: 0001481765 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-30489 FILM NUMBER: 10582151 MAIL ADDRESS: STREET 1: C/O LIFEVANTAGE CORPORATION STREET 2: 11545 W. BERNARDO CT., SUITE 301 CITY: SAN DIEGO STATE: CA ZIP: 92127 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 c95838_4x0.xml MAIN DOCUMENT DESCRIPTION X0303 4 2010-02-04 0000849146 Lifevantage Corp LFVN 0001481765 Lu C. Mike 11545 W. BERNARDO COURT SUITE 301 SAN DIEGO CA 92127 1 0 0 0 8% Convertible Debenture 0.20 2010-02-04 4 J 0 499500 A 2010-02-04 Common Stock 2497500 499500 D Warrant (Right to Buy) 0.50 2010-02-04 4 J 0 1250000 A 2010-02-04 2015-02-04 Common Stock 1250000 1250000 D Received in exchange for cancellation of promissory note in principal amount of $500,000. The 8% Convertible Debenture is convertible at any time by the holder into shares of common stock at a conversion price equal to $0.20 per share, subject to adjustment, and expires upon repayment and has a maturity date of February 4, 2012. The expiration date is the earlier of February 4, 2015 or (a) a merger or consolidation where the issuer is not the surviving corporation or a reverse triangular merger where the issuer's capital stock is converted into other property by virtue of the merger or (b) a sale of all or substantially all of the assets of the issuer, where the stockholders of the issuer immediately prior to such event do not retain at least 50% of the voting power of the acquiring or surviving entity immediately after the acquisition or sale. /s/ Mike Lu 2010-02-08 -----END PRIVACY-ENHANCED MESSAGE-----