0001209191-11-059778.txt : 20111206 0001209191-11-059778.hdr.sgml : 20111206 20111206173136 ACCESSION NUMBER: 0001209191-11-059778 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111202 FILED AS OF DATE: 20111206 DATE AS OF CHANGE: 20111206 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: 10813 S. RIVER FRONT PARKWAY STREET 2: STE. 500 CITY: SOUTH JORDAN STATE: UT ZIP: 84095 BUSINESS PHONE: 858-312-8000 MAIL ADDRESS: STREET 1: 10813 S. RIVER FRONT PARKWAY STREET 2: STE. 500 CITY: SOUTH JORDAN STATE: UT ZIP: 84095 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: 111246562 MAIL ADDRESS: STREET 1: AEOLUS PHARMACEUTICALS, INC. STREET 2: PO BOX 14287 CITY: RTP STATE: NC ZIP: 27709-4287 4 1 c25651_4x0.xml MAIN DOCUMENT DESCRIPTION X0304 4 2011-12-02 0000849146 Lifevantage Corp LFVN 0001120570 CRAPO JAMES D 11545 W. BERNARDO CT. SUITE 301 SAN DIEGO CA 92127 1 0 0 0 Common Stock 2011-12-02 4 S 0 16500 1.4458 D 733375 D Common Stock 2011-12-05 4 S 0 56934 1.4367 D 676441 D /s/James D. Crapo 2011-12-05