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