0000849146-23-000002.txt : 20230103 0000849146-23-000002.hdr.sgml : 20230103 20230103164906 ACCESSION NUMBER: 0000849146-23-000002 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20221229 FILED AS OF DATE: 20230103 DATE AS OF CHANGE: 20230103 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Mauro Garry Paul CENTRAL INDEX KEY: 0001436020 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35647 FILM NUMBER: 23502847 MAIL ADDRESS: STREET 1: 6400 S. FIDDLER'S GREEN CIRCLE STREET 2: SUITE 1970 CITY: GREENWOOD VILLAGE STATE: X1 ZIP: 80111 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_167278252520746.xml FORM 4 X0306 4 2022-12-29 0 0000849146 Lifevantage Corp LFVN 0001436020 Mauro Garry Paul 3300 TRIUMPH BLVD, SUITE 700 LEHI UT 84043 1 0 0 0 Common Stock 2022-12-29 5 G 0 E 125000 0 D 59769 D Common Stock 2022-12-29 5 G 0 E 25000 0 A 25000 I By The Francesco A. Mauro Trust of 2021 Common Stock 2022-12-29 5 G 0 E 25000 0 A 25000 I By The Andrew H. Mauro Trust of 2021 Common Stock 2022-12-29 5 G 0 E 25000 0 A 25000 I By The Dominic C. Mauro Trust of 2021 Common Stock 2022-12-29 5 G 0 E 25000 0 A 25000 I By The David W.B. Mauro Trust of 2021 Common Stock 2022-12-29 5 G 0 E 25000 0 A 25000 I By The Alexandra P. Mauro Trust of 2021 On December 29, 2022, the Reporting Person transferred 25,000 shares of the Issuer's common stock to each of five irrevocable trusts of which the Reporting Person is the trustee and his adult children are beneficiaries. These shares are held by The Francesco A. Mauro Trust of 2021, of which the Reporting Person is trustee and his adult child is beneficiary. The Reporting Person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein, if any. These shares are held by The Andrew H. Mauro Trust of 2021, of which the Reporting Person is trustee and his adult child is beneficiary. The Reporting Person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein, if any. These shares are held by The Dominic C. Mauro Trust of 2021, of which the Reporting Person is trustee and his adult child is beneficiary. The Reporting Person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein, if any. These shares are held by The David W.B. Mauro Trust of 2021, of which the Reporting Person is trustee and his adult child is beneficiary. The Reporting Person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein, if any. These shares are held by The Alexandra P. Mauro Trust of 2021, of which the Reporting Person is trustee and his adult child is beneficiary. The Reporting Person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein, if any. Alissa Neufeld, Power of Attorney for Garry P. Mauro 2023-01-03