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Filing Details

Issuer

Cik	Name	Symbol	Sector (SIC)	IRS No
1410428	Form Holdings Corp.	FH	()	4

Insiders

Cik	Name	Reported Address	Insider Title	Director	Officer	Large Shareholder	Other
1259062	R Andrew Heyer	C/O Form Holdings Corp., 780 Third Avenue New York NY 10017		Yes	No	No	No

Reported Non-Derivative Transactions

Sec. Name	Acquisiton - Disposition	Date	Amount	Price	Remaning Holdings	Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
Common Stock	Acquisiton	2017-09-13	100,000	$1.32	115,000	No	4	P	Direct

Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
No	4	P	Direct

Reported Non-Derivative Holdings

Sec. Name	Remaning Holdings	Nature of Ownership	Explanation
Common Stock	2,338,690	Indirect	See footnote

Footnotes

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.