0000849146-21-000060.txt : 20210706 0000849146-21-000060.hdr.sgml : 20210706 20210706160645 ACCESSION NUMBER: 0000849146-21-000060 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210701 FILED AS OF DATE: 20210706 DATE AS OF CHANGE: 20210706 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Rose Justin CENTRAL INDEX KEY: 0001649432 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35647 FILM NUMBER: 211074121 MAIL ADDRESS: STREET 1: C/O LIFEVANTAGE CORPORATION STREET 2: 9785 S. MONROE ST. SUITE 300 CITY: SANDY STATE: UT ZIP: 84070 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Lifevantage Corp CENTRAL INDEX KEY: 0000849146 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 841097796 STATE OF INCORPORATION: DE FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: 3300 TRIUMPH BLVD STREET 2: SUITE 700 CITY: LEHI STATE: UT ZIP: 84043 BUSINESS PHONE: 801-432-9000 MAIL ADDRESS: STREET 1: 3300 TRIUMPH BLVD STREET 2: SUITE 700 CITY: LEHI STATE: UT ZIP: 84043 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 wf-form4_162560198713927.xml FORM 4 X0306 4 2021-07-01 0 0000849146 Lifevantage Corp LFVN 0001649432 Rose Justin 3300 NORTH TRIUMPH BLVD #700 LEHI UT 84043 0 1 0 0 Chief Sales &Marketing Officer Common Stock 2021-07-01 4 M 0 1177 0 A 154729 D Common Stock 2021-07-01 4 M 0 215 0 A 154944 D Common Stock 2021-07-01 4 F 0 1287 9.44 D 153657 D Performance Stock Units 2021-07-01 4 M 0 1177 0 D Common Stock 1177.0 0 D Performance Stock Units 2021-07-01 4 M 0 215 0 D Common Stock 215.0 860 D On November 15, 2018 the reporting person was granted PSUs which vest only to the extent the specified financial performance criteria are achieved and subject to the reporting person's continued service with the issuer, as follows: (i) 5/12 of the earned award vested on the first anniversary of the grant date and (ii) an additional 1/12 of the earned award will vest on the first day of each calendar quarter thereafter. The reporting person initially reported the number of shares that were eligible to be earned at target-level performance achievement. The performance criteria were achieved at a level above target; accordingly, the reporting person is eligible to earn 162% of the target number of units. The actual number of shares that vested on the reported transaction date was 162% of the at-target number of shares subject to vesting on that date and the number of PSUs beneficially owned following the reported transaction has been updated to reflect 162% of the target number of units. Performance Stock Units ("PSUs") convert into common stock on a one-for-one basis. On December 5, 2019 the reporting person was granted PSUs which vest only to the extent specified financial performance criteria are achieved and subject to the reporting person's continued service with the issuer, as follows: (i) 5/12 of the earned award vested on the first anniversary of the grant date and (ii) an additional 1/12 of the earned award will vest on the first day of each calendar quarter thereafter. The reporting person initially reported the number of shares that were eligible to be earned at target-level performance achievement. The performance criteria were achieved at a level below target; accordingly, the reporting person is eligible to earn 50.99% of the target number of units. The actual number of shares that vested on the reported transaction date was 50.99% of the at-target number of shares subject to vesting on that date and the number of PSUs beneficially owned following the reported transaction has been updated to reflect 50.99% of the target number of units. These shares were withheld to satisfy tax withholding obligations in connection with the vesting of PSU awards and stock unit awards granted to the reporting person on November 15, 2018 and December 5, 2019. /s/ Justin Rose 2021-07-06