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20260415_UNSP_Penambahan Modal Tanpa HMETD_32070739_lamp4.pdf
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Page 1 OCR 0.928
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 E@UITY-LINKED REDEEMABLE NOTES DUE 2017 (ISIN: XSO474326260). 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
Page 2 OCR 0.877
(at-debtrestructuring@bny.com) and the Issuer (at Jebt.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: SUNDARESAN HARIHARAN 2. | Principal Amount of Notes held by Noteholder: ae 3. Clearing System: aa / Clearstream (strike through the one that is not 4. | Euroclear / Clearstream Direct Participant Name: DBS BANK NON-US SEC AC PB CLIENTS 5. | Euroclear / Clearstream Direct Participant Number: 15192 6. | Electronic Acceptance Blocking Instruction Reference Number: (XOU MUST INCLUDE THE BLOCKING INSTRUCTION CSTDY00147070048
Page 3 OCR 0.855
1. | Full Name: SUNDARESAN HARIHARAN/KALA RAMASESHAN 2 Kekrenas 11 TANJONG RHU ROAD, 15-01 THE WATERSIDE SINGAPORE 436896 3. | Telephone Number: (65)97803507 4. | Email: SUNDARESAN.HARIHARAN@GMAIL.COM Noteholder Details (if not a natural person) 1. | Full Name of the Company: 2. Registered Address of the Company: 3. | Name and Title of Authorised Employee: 4. | Telephone Number of Authorised Employee: 5. Email of Authorised Employee: C-BEST Account Details 1. | C-BEST Bank/Custodian Name: DBS BANK LIMITED 20 | ecoumt Nama at BEST SUNDARESAN HARIHARAN/KALA RAMASESHAN Bank/Custodian: ag Pee asa S-195668 pg Perantara ROHIT SARAF 5. | Email of Contact Person: ROHITSARAF@DBS.COM 6. | Telephone Number of Contact pi Person: 7. | Fax Number of Contact Person (if applicable): Capitalised terms shall have the meanings ascribed to them in the Consent Solicitation Memorandum. BY SUBMITTING 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.
Page 4 OCR 0.874
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 (un Name: SANDA RESAV NARIMAKAN Dat NA PERAYAAN Lon
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