0001209191-11-018701.txt : 20110317 0001209191-11-018701.hdr.sgml : 20110317 20110317173214 ACCESSION NUMBER: 0001209191-11-018701 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110315 FILED AS OF DATE: 20110317 DATE AS OF CHANGE: 20110317 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: 11696000 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 c14336_4x0.xml MAIN DOCUMENT DESCRIPTION X0303 4 2011-03-15 0000849146 Lifevantage Corp LFVN 0001481886 Robinson Douglas C. 11545 W. BERNARDO CT. SUITE 301 SAN DIEGO CA 92127 1 1 0 0 President & CEO Stock Option (Right to Buy) 0.75 2011-03-15 4 A 0 610000 0 A 2021-03-14 Common Stock 610000 610000 D Stock Option (Right to Buy) 1.20 2011-03-15 4 A 0 500000 0 A 2021-03-14 Common Stock 500000 500000 D Stock Option (Right to Buy) 1.75 2011-03-15 4 A 0 500000 0 A 2021-03-14 Common Stock 500000 500000 D Stock Option (Right to Buy) 0.80 2011-03-15 4 D 0 80000 0 D 2021-01-20 Common Stock 80000 40000 D This option vests on the date of grant with respect to 110,000 shares of common stock and becomes exercisable with respect to 500,000 shares of common stock as of June 30, 2012, only if Mr. Robinson has continuously rendered service to the Company through the applicable vesting date. This option fully vests and becomes exercisable as of June 30, 2013 only if Mr. Robinson has continuously rendered service to the Company through the applicable vesting date. This option fully vests and becomes exercisable as of June 30, 2014 only if Mr. Robinson has continuously rendered service to the Company through the applicable vesting date. In connection with the commencement of his employment as the Company's President and Chief Executive Officer on 3/15/2011, Mr. Robinson agreed to the cancellation and forfeiture of 80,000 unvested shares of common stock underlying the option to purchase 120,000 shares of common stock which was granted to him on 1/20/2011 in his capacity as a non-employee director of the Company. /s/ Doug Robinson 2011-03-15