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20260415_UNSP_Penambahan Modal Tanpa HMETD_32070739_lamp8.pdf
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Page 1 OCR 0.918
ANNEXURE II FORM OF NOTICE OF NOTEHOLDER INFORMATION PT BAKRIE SUMATERA PLANTATIONS TBK. (incorporated under the laws of the Republic of Indonesia) RELATING TO THE CONSENT SOLICITATION MEMORANDUM (THE "CONSENT SOLICITATION MEMORANDUM") DATED 23 JANUARY 2026 FOR THE US$100 MILLION 8.0 PER CENT. SECURED EGUITY-LINKED REDEEMABLE NOTES DUE 2017 (ISIN: XS0474326260). YOU MUST SUBMIT AN ELECTRONIC INSTRUCTION IN THE CONSENT SOLICITATION (WHETHER YOU VOTE FOR OR AGAINST, OR VOTE TO ABSTAIN, IN RESPECT OF THE WRITTEN RESOLUTION) TO BE ELIGIBLE FOR THE SHARE SETTLEMENT IF THE WRITTEN RESOLUTION IS PASSED. IF THE WRITTEN RESOLUTION IS PASSED YOU MUST COMPLETE AND SUBMIT THIS FORM WITHIN 30 CALENDAR DAYS AFTER THE ISSUER NOTIFIES HOLDERS THAT THE WRITTEN RESOLUTION HAS BEEN EXECUTED TO ELECT TO RECEIVE THE SHARES SETTLEMENT. NOTEHOLDERS THAT DO NOT SUBMIT AN ELECTRONIC INSTRUCTION AND SUBMIT THIS FORM WILL NOT BE ENTITLED TO RECEIVE THE SHARE SETTLEMENT AND WILL RECEIVE THE CASH SETTLEMENT INSTEAD. Following the notice by the Issuer through the Clearing Systems, that the Written Resolution has been executed, Noteholders should complete this form and submit it by email to the Tabulation Agent (at: debtrestructuring@bny.com) and the Issuer (at debt.restructuring@bakriesumatera.com) within 30 calendar days Of such notice if they wish to receive Shares in exchange for their Notes. Details of the Notes 1. | Name of Noteholder: PT. SAMUEL SEKURITAS INDONESIA 2. | Principal Amount of Notes held by A. US$ 7,795,000 (PT. BAKRIE CAPITAL, INDONESIA) Noteholder: B. USS 6,600,000 (INDO, ALAM RESOURCES PTE. LTD) 3. | Clearing System: Euroclear DEUTSCHE BANK AG, SINGAPORE A'/C DCS CLIENT 4, | Euroclear/ Clearstream Direct Participant Name: 5. | Euroclear// Clearstream Direct Participant Number: 10266 6. Electronic Acceptance Blocking Instruction Reference Number: EB REP (YOU MUST INCLUDE THE 7970612 BLOCKING INSTRUCTION REFERENCE NUMBER YOU RECEIVED FROM YOUR CLEARING SYSTEM FOR THIS FORM TO BE PROPERLY COMPLETED) 37
Page 2 OCR 0.899
Noteholder Details fifa natural person) Full Name: Address: Telephone Number: Email: Noteholder Details (if not a natural person) Full Name of the Company: PT. SAMUEL SEKURITAS INDONESIA Registered Address of the Company: MENARA IMPERIUM LT. 21 Name and Title of Authorised Employee: LIEM HISDIYANTO Telephone Number of Authorised Employee: 4 62-21-28549188 & Email of Authorised Employee: hisdi.iem@samuel.co.id C-BEST Account Details (A) C-BEST Bank/Custodian Name: C-BEST Account Name at C-BEST Bank/Custodian: PT. BAKRIE CAPITAL INDONESIA Account Number at C-BEST Bank/Custodian: IFOO1-4046-001-96 Contact Person at C-BEST Bank/Custodian above: KEVIN HUTAMA/ HULWEI Email of Contact Person: Settlement@samuel.co.id Telephone Number of Contact Person: 462-21-28548361/161/121. Fax Number of Contact Person (if applicable): 38
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C-BEST Account Details (B 1. | C-BEST Bank/Custodian Name: C-BEST 2, | Account Name at C-BEST Bank/Custodian: INDO ALAM RESOURCES PTE. LTD 3. | Account Number at C-BEST Bank/Custodian: IF001-DP57-001-91 4. | Contact Person at C-BEST Bank/Custodian above: KEVIN HUTAMA/ HULWEN/ DYANY THEMA 5. | Email of Contact Person: Settlement@samuel.co.id 6. | Telephone Number of Contact 462-21-28548361/161/121 Person: l 7. | Fax Number of Contact Person (if applicable): ta Capitalised terms shall have the meanings ascribed to them in the Consent Solicitation Memorandum. BY SUSMITTING THIS FORM, THE NOTEHOLDER SHALL BE DEEMED TO HAVE MADE THE ACKNOWLEDGEMENTS, REPRESENTATIONS, WARRANTIES AND UNDERTAKINGS SET OUT IN "TERMS OF THE CONSENT SOLICTITATION - 8. ACKNOWLEDGEMENTS, REPRESENTATIONS, WARRANTIES AND UNDERTAKINGS" IN THE CONSENT SOLICITIATION MEMORANDUM, The Noteholder agrees by submitting this form, that upon its receipt of the Shares it is entitled to pursuant to the terms of the Consent Solicitation, it will release and discharge the Issuer, the Guarantors, their subsidiaries and any other obligors and their respective affiliates, directors, officers and employees, from all ciaims relating to the Notes howsoever arising, including all amounts that may be owing in respect of such Notes whether principal, interest, penalty or otherwise, whether known or unknown, contingent or certain, in contract or in tort, and whether liguidated or unliguidated. Signature of Noteholder or Authorised Employee 2 . Name: LIEM HISDIYANTO Title —: PRESIDENT DIRECTOR Date : 18 FEB 2026 39
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PT. SAMUEL SEKURITAS INDONESIA Registered
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PT. BAKRIE CAPITAL INDONESIA Account
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INDO ALAM RESOURCES PTE. LTD
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