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