0001445305-13-001737.txt : 20130730
0001445305-13-001737.hdr.sgml : 20130730
20130730122324
ACCESSION NUMBER: 0001445305-13-001737
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20130529
FILED AS OF DATE: 20130730
DATE AS OF CHANGE: 20130730
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: 13994857
MAIL ADDRESS:
STREET 1: 9815 S. MONROE STREET, SUITE 100
CITY: SANDY
STATE: UT
ZIP: 84070
4
1
wf-form4_137520139379018.xml
FORM 4
X0306
4
2013-05-29
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
2013-05-29
4
F
0
1365
2.35
D
270735
D
The shares were withheld to satisfy tax withholding obligations in connection with the partial vesting of a restricted stock award granted on May 29, 2012.
/s/ Rob Cutler, Attorney-in-Fact
2013-07-30