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