0001209191-11-035555.txt : 20110620
0001209191-11-035555.hdr.sgml : 20110620
20110620165343
ACCESSION NUMBER: 0001209191-11-035555
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20110526
FILED AS OF DATE: 20110620
DATE AS OF CHANGE: 20110620
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
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: CRAPO JAMES D
CENTRAL INDEX KEY: 0001120570
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-30489
FILM NUMBER: 11921375
MAIL ADDRESS:
STREET 1: AEOLUS PHARMACEUTICALS, INC.
STREET 2: PO BOX 14287
CITY: RTP
STATE: NC
ZIP: 27709-4287
4
1
c18999_4x0.xml
MAIN DOCUMENT DESCRIPTION
X0303
4
2011-05-26
0000849146
Lifevantage Corp
LFVN
0001120570
CRAPO JAMES D
11545 W. BERNARDO CT.
SUITE 301
SAN DIEGO
CA
92127
1
0
0
0
Common Stock
2011-05-26
4
C
0
124875
0.20
A
749875
D
8% Convertible Debenture
0.20
2011-05-26
4
C
0
24975
0
D
2009-12-11
2011-12-11
Common Stock
124875
0
D
/s/James D. Crapo
2011-06-20