0001445305-13-001541.txt : 20130625
0001445305-13-001541.hdr.sgml : 20130625
20130625155906
ACCESSION NUMBER: 0001445305-13-001541
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20130624
FILED AS OF DATE: 20130625
DATE AS OF CHANGE: 20130625
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: 9815 S. MONROE STREET
STREET 2: SUITE 100
CITY: SANDY
STATE: UT
ZIP: 84070
BUSINESS PHONE: 801-432-9000
MAIL ADDRESS:
STREET 1: 9815 S. MONROE STREET
STREET 2: SUITE 100
CITY: SANDY
STATE: UT
ZIP: 84070
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: Urban Robert M.
CENTRAL INDEX KEY: 0001551128
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35647
FILM NUMBER: 13932117
MAIL ADDRESS:
STREET 1: 9815 S. MONROE STREET, SUITE 100
CITY: SANDY
STATE: UT
ZIP: 84070
4
1
wf-form4_137219033614342.xml
FORM 4
X0306
4
2013-06-24
0
0000849146
Lifevantage Corp
LFVN
0001551128
Urban Robert M.
9815 S. MONROE STREET
SUITE 100
SANDY
UT
84070
0
1
0
0
Chief Operating Officer
Common Stock
2013-06-24
4
A
0
256000
0
A
272100
D
These shares were acquired pursuant to a restricted stock award granted June 24, 2013, which vests in four equal annual installments on each of June 24, 2014, June 24, 2015, June 24, 2016, and June 24, 2017, subject to continued service with the Company.
/s/ Rob Cutler, Attorney-in-Fact
2013-06-24