0001144204-17-029000.txt : 20170523
0001144204-17-029000.hdr.sgml : 20170523
20170523093944
ACCESSION NUMBER: 0001144204-17-029000
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170519
FILED AS OF DATE: 20170523
DATE AS OF CHANGE: 20170523
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: FORM Holdings Corp.
CENTRAL INDEX KEY: 0001410428
STANDARD INDUSTRIAL CLASSIFICATION: PATENT OWNERS & LESSORS [6794]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 780 THIRD AVENUE, 12TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10017
BUSINESS PHONE: (212) 309-7549
MAIL ADDRESS:
STREET 1: 780 THIRD AVENUE, 12TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10017
FORMER COMPANY:
FORMER CONFORMED NAME: Vringo Inc
DATE OF NAME CHANGE: 20070822
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: HEYER ANDREW R
CENTRAL INDEX KEY: 0001259062
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-34785
FILM NUMBER: 17862828
MAIL ADDRESS:
STREET 1: C/O MISTRAL EQUITY PARTNERS
STREET 2: 650 FIFTH AVENUE 31ST FL
CITY: NEW YORK
STATE: NY
ZIP: 10019
4
1
v467618_4.xml
OWNERSHIP DOCUMENT
X0306
4
2017-05-19
0
0001410428
FORM Holdings Corp.
FH
0001259062
HEYER ANDREW R
C/O FORM HOLDINGS CORP.,
780 THIRD AVENUE, 12TH FLOOR
NEW YORK
NY
10017
1
0
0
0
Common Stock
2017-05-19
4
P
0
10000
1.4899
A
10000
D
Common Stock
2338690
I
See footnote
Common Stock
2017-05-22
4
P
0
5000
1.66
A
15000
D
Common Stock
2338690
I
See footnote
Mistral Spa Holdings, LLC ("MSH"), a Delaware limited liability company, is the record holder of these shares of common stock beneficially owned by Mr. Heyer. Mr. Heyer is the managing member and the managing partner of Mistral Capital Management, LLC ("MCM"), which is the sole manager of MSH. By reason of the provisions of Rule 16a-1 of the Exchange Act, MCM and Mr. Heyer may be deemed to be beneficial owners of certain of the securities that are deemed to be beneficially owned by MSH. Mr. Heyer disclaims beneficial ownership of the securities owned by MSH except to the extent of Mr. Heyer's pecuniary interest therein.
/s/ Andrew R. Heyer
2017-05-23