0001144204-14-056556.txt : 20140917
0001144204-14-056556.hdr.sgml : 20140917
20140917164759
ACCESSION NUMBER: 0001144204-14-056556
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20130219
FILED AS OF DATE: 20140917
DATE AS OF CHANGE: 20140917
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: MEDIFAST INC
CENTRAL INDEX KEY: 0000910329
STANDARD INDUSTRIAL CLASSIFICATION: MISCELLANEOUS FOOD PREPARATIONS & KINDRED PRODUCTS [2090]
IRS NUMBER: 133714405
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 11445 CRONHILL DRIVE
CITY: OWINGS MILLS
STATE: MD
ZIP: 21117
BUSINESS PHONE: 7327640619
MAIL ADDRESS:
STREET 1: 11445 CRONHILL DRIVE
CITY: OWINGS MILLS
STATE: MD
ZIP: 21117
FORMER COMPANY:
FORMER CONFORMED NAME: HEALTHRITE INC
DATE OF NAME CHANGE: 19951120
FORMER COMPANY:
FORMER CONFORMED NAME: XX
DATE OF NAME CHANGE: 19950619
FORMER COMPANY:
FORMER CONFORMED NAME: 00
DATE OF NAME CHANGE: 19950619
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: LAVIN GEORGE
CENTRAL INDEX KEY: 0001460671
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-31573
FILM NUMBER: 141108435
MAIL ADDRESS:
STREET 1: C/O MEDIFAST, INC.
STREET 2: 3600 CRONDALL LANE
CITY: OWINGS MILLS
STATE: MD
ZIP: 21117
4
1
v389392_4.xml
OWNERSHIP DOCUMENT
X0306
4
2013-02-19
1
0000910329
MEDIFAST INC
MED
0001460671
LAVIN GEORGE
C/O MEDIFAST, INC.
3600 CRONDALL LANE
OWINGS MILLS
MD
21117
1
0
0
0
Common Stock
2013-02-19
4
A
0
750
0.00
A
24641
D
Common Stock
2013-03-31
4
A
0
456
0.00
A
25097
D
Common Stock
2013-07-31
4
D
0
312
0.00
D
24785
D
These shares were granted to the reporting person under the 2012 Share Incentive Plan for satisfactory participation on the Board of Directors. These shares will vest in full on 1/1/2015. A portion of these shares were subsequently forfeited by the reporting person (see Footnote 3 below).
These shares were issued to the reporting person under the 2012 Share Incentive Plan in lieu of meeting fees.
These shares represent a portion of the shares described in Footnote 1, which were forfeited by the reporting person in connection with his resignation from the Board of Directors.
/s/ Jason L. Groves, Esq.
2014-09-17