Initial Statement of Beneficial Ownership (3)

FORM 3	UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES	OMB APPROVAL OMB Number: 3235-0104 Estimated average burden hours per response... 0.5
	Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940

1. Name and Address of Reporting Person ^*

Charkow Jason

2. Date of Event Requiring Statement (MM/DD/YYYY) 1/17/2017

3. Issuer Name and Ticker or Trading Symbol

FORM Holdings Corp. [FH]

(Last) (First) (Middle)

C/O FORM HOLDINGS CORP., 780 THIRD AVENUE, 12TH FLOOR

4. Relationship of Reporting Person(s) to Issuer (Check all applicable)

_____ Director _____ 10% Owner
___ X ___ Officer (give title below) _____ Other (specify below)
VP Legal & Business Affairs /

(Street)

NEW YORK, NY 10017

(City) (State) (Zip)

5. If Amendment, Date Original Filed (MM/DD/YYYY)

6. Individual or Joint/Group Filing (Check Applicable Line)

_ X _ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Beneficially Owned
1.Title of Security (Instr. 4)	2. Amount of Securities Beneficially Owned (Instr. 4)	3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	4. Nature of Indirect Beneficial Ownership (Instr. 5)

*Table II - Derivative Securities Beneficially Owned ( e.g.* , puts, calls, warrants, options, convertible securities)**
1. Title of Derivate Security (Instr. 4)	2. Date Exercisable and Expiration Date (MM/DD/YYYY)		3. Title and Amount of Securities Underlying Derivative Security (Instr. 4)		4. Conversion or Exercise Price of Derivative Security	5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
1. Title of Derivate Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	4. Conversion or Exercise Price of Derivative Security		6. Nature of Indirect Beneficial Ownership (Instr. 5)
Stock Option	⁽¹⁾	1/13/2023	Common Stock	10000	$32.40	D
Stock Option	⁽²⁾	10/17/2023	Common Stock	10000	$27.70	D
Stock Option	⁽³⁾	1/15/2025	Common Stock	15000	$5.10	D
Stock Option	⁽⁴⁾	4/4/2026	Common Stock	150000	$1.55	D

Explanation of Responses:
( 1)	These options to purchase shares of common stock of the Issuer vest quarterly over 12 quarters starting January 31, 2013.
( 2)	These options to purchase shares of common stock of the Issuer vest quarterly over 12 quarters starting October 17, 2013.
( 3)	These options to purchase shares of common stock of the Issuer vest quarterly over 12 quarters starting January 15, 2015.
( 4)	These options to purchase shares of common stock of the Issuer vest quarterly over 12 quarters starting April 4, 2016.

Remarks:
Exhibit List - Exhibit 24 - Power of Attorney

Reporting Owners
Reporting Owner Name / Address	Relationships
Reporting Owner Name / Address	Director	10% Owner	Officer	Other
Charkow Jason C/O FORM HOLDINGS CORP. 780 THIRD AVENUE, 12TH FLOOR NEW YORK, NY 10017			VP Legal & Business Affairs

Signatures
/s/ Jason Charkow		1/20/2017
^** Signature of Reporting Person		Date

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
*	If the form is filed by more than one reporting person, see Instruction 5(b)(v).
**	Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note:	File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.