SEC Form 4 · accession 0000849146-19-000004
Lifevantage Corp · LFVN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Darren Jay Jensen
Officer — Chief Executive Officer · Director
Period of report
Dec 31, 2018
Accepted (ET)
Jan 3, 2019 · 2:45 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000849146
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Dec 31, 2018 | M | 178,571 | $0.00 | A | 288,071 | D | |
| Common StockF3 | Dec 31, 2018 | F | 88,036 | $13.19 | D | 200,035 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Performance Stock UnitsF2,F1 | — | Dec 31, 2018 | M | 178,571 | D | — | Dec 31, 2018 | Common Stock | 178,571 | 0 | D |
Explanation of responses
- F1On March 28, 2016, the reporting person was granted Performance Stock Units ("PSUs"), subject to a three-year performance period of 1/1/2016 through 12/31/2018, subject to earlier expiration upon a change in control of the issuer ("Performance Period"). Subject generally to the reporting person's continued service with the issuer, each PSU represents a contingent right for such person to receive, within 30 days after the end of the Performance Period, a distribution of common shares of the issuer equal to 0% to 116.7% of the previously reported target number of PSUs. Based on the issuer's total stockholder return performance during the Performance Period, the actual number of shares distributed was 116.7% of the target number of PSUs.
- F2PSUs convert into common stock on a one-for-one basis.
- F3These shares were withheld to satisfy tax withholding obligations in connection with the vesting of a PSU award granted on March 28, 2016.