0001209191-11-035560.txt : 20110620
0001209191-11-035560.hdr.sgml : 20110620
20110620165724
ACCESSION NUMBER: 0001209191-11-035560
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20110525
FILED AS OF DATE: 20110620
DATE AS OF CHANGE: 20110620
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: McCord Joe M
CENTRAL INDEX KEY: 0001356119
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-30489
FILM NUMBER: 11921397
MAIL ADDRESS:
STREET 1: 6400 S FIDDLER'S GREEN CIRCLE
STREET 2: SUITE 1970
CITY: ENGLEWOOD
STATE: CO
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
c19001_4x0.xml
MAIN DOCUMENT DESCRIPTION
X0303
4
2011-05-25
0000849146
Lifevantage Corp
LFVN
0001356119
McCord Joe M
11545 W. BERNARDO CT.
SUITE 301
SAN DIEGO
CA
92127
1
0
0
0
Common Stock
2011-05-25
4
C
0
374625
0.20
A
1981425
D
8% Convertible Debenture
0.20
2011-05-25
4
C
0
74925
0
D
2009-12-11
2011-12-11
Common Stock
374625
0
D
/s/ Joe M. McCord
2011-06-20