0000903496-11-000001.txt : 20111212 0000903496-11-000001.hdr.sgml : 20111212 20111212145138 ACCESSION NUMBER: 0000903496-11-000001 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111209 FILED AS OF DATE: 20111212 DATE AS OF CHANGE: 20111212 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HASTINGS CARL W CENTRAL INDEX KEY: 0000903496 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19932 FILM NUMBER: 111255957 MAIL ADDRESS: STREET 1: 136 CHESTERFIELD INDUSTRIAL BLVD CITY: CHESTERFIELD STATE: MO ZIP: 63005 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: RELIV INTERNATIONAL INC CENTRAL INDEX KEY: 0000768710 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 371172197 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 136 CHESTERFIELD INDUSTRIAL BLVD STREET 2: P O BOX 405 CITY: CHESTERFIELD STATE: MO ZIP: 63006-0405 BUSINESS PHONE: 636-537-9715 MAIL ADDRESS: STREET 1: 136 CHESTERFIELD INDUSTRIAL BLVD STREET 2: P O BOX 405 CITY: CHESTERFIELD STATE: MO ZIP: 63006-0405 FORMER COMPANY: FORMER CONFORMED NAME: AMERICAN LIFE INVESTORS INC DATE OF NAME CHANGE: 19920315 4 1 edgar.xml PRIMARY DOCUMENT X0304 4 2011-12-09 0000768710 RELIV INTERNATIONAL INC RELV 0000903496 HASTINGS CARL W 136 CHESTERFIELD INDUSTRIAL BOULEVARD CHESTERFIELD MO 63005 0 1 0 0 Vice President Common Stock 2011-12-09 4 P 0 10000 1.29 A 614239 D Jonathan K Miller, Attorney in Fact for Carl Hastings 2011-12-12