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