-----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, Tna/omawnuMuQMD1LT0l4TRFJqdv8xXW6TQ470MU0BxZ2XrEJMdNYeH1a66q/Dsl MfPi2/UdqKI/TvxOH3ZT2g== 0001209191-11-004608.txt : 20110124 0001209191-11-004608.hdr.sgml : 20110124 20110124163058 ACCESSION NUMBER: 0001209191-11-004608 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110120 FILED AS OF DATE: 20110124 DATE AS OF CHANGE: 20110124 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Robinson Douglas C. CENTRAL INDEX KEY: 0001481886 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-30489 FILM NUMBER: 11544051 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 c11360_4x0.xml MAIN DOCUMENT DESCRIPTION X0303 4 2011-01-20 0000849146 Lifevantage Corp LFVN 0001481886 Robinson Douglas C. 11545 W. BERNARDO CT. SUITE 301 SAN DIEGO CA 92127 1 0 0 0 Stock Option (Right to Buy) 0.80 2011-01-20 4 A 0 120000 0 A 2021-01-20 Common Stock 120000 120000 D This option vests and becomes exercisable in full on the date of grant. /s/ Douglas C. Robinson 2011-01-20 -----END PRIVACY-ENHANCED MESSAGE-----