0000849146-23-000117.txt : 20230907 0000849146-23-000117.hdr.sgml : 20230907 20230907160657 ACCESSION NUMBER: 0000849146-23-000117 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230905 FILED AS OF DATE: 20230907 DATE AS OF CHANGE: 20230907 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: 231242309 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 wk-form4_1694117209.xml FORM 4 X0508 4 2023-09-05 0 0000849146 Lifevantage Corp LFVN 0001436020 Mauro Garry Paul 3300 TRIUMPH BLVD, SUITE 700 LEHI UT 84043 1 0 0 0 0 Common Stock 2023-09-05 4 P 0 425 7.632 A 64189 D Common Stock 2023-09-05 4 P 0 110 7.632 A 25280 I By The Francesco A. Mauro Trust of 2021 Common Stock 2023-09-05 4 P 0 110 7.632 A 25280 I By The Andrew H. Mauro Trust of 2021 Common Stock 2023-09-05 4 P 0 110 7.632 A 25280 I By The David W.B. Mauro Trust of 2021 Common Stock 2023-09-05 4 P 0 110 7.632 A 25280 I By The Dominic C. Mauro Trust of 2021 Common Stock 2023-09-05 4 P 0 110 7.632 A 25280 I By The Alexandra P. Mauro Trust of 2021 Common Stock 2023-09-05 4 P 0 25 7.632 A 25 I By Garry Paul Mauro SEP IRA Alissa Neufeld, Power of Attorney for Garry P. Mauro 2023-09-07