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20260408_MIKA_Laporan Bulanan Registrasi Pemegang Efek//Perubahan Struktur Pemegang Saham_32068812.pdf
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Extracted text 11
Page 1
Go To English Page Nomor Surat 22/MIKA-IV/2026 Nama Perusahaan PT Mitra Keluarga Karyasehat Tbk. Kode Emiten MIKA Papan Pencatatan Utama Lampiran 1 Perihal Laporan Bulanan Registrasi Pemegang Efek Bersama ini PT Mitra Keluarga Karyasehat Tbk. menyatakan: 1. Bertanggung jawab atas penyusunan dan penyajian Laporan Bulanan Registrasi Pemegang Efek (LBRE). 2. Semua informasi dalam LBRE telah dimuat secara lengkap dan benar, tidak mengandung informasi atau fakta material yang tidak benar, dan tidak menghilangkan informasi atau fakta material. 3. Perhitungan Free Float telah disajikan sesuai dengan Peraturan Bursa Nomor I-A tentang Pencatatan Saham dan Efek Bersifat Ekuitas Selain Saham yang Diterbitkan oleh Perusahaan Tercatat, termasuk telah mengeluarkan kepemilikan saham oleh pihak Pengendali dan Afiliasi dari Pengendali, dan Afiliasi dari Pemilik Manfaat; dimiliki oleh anggota Dewan Komisaris atau anggota Direksi; dan saham yang telah dibeli kembali oleh perusahaan. Direksi atas nama PT Mitra Keluarga Karyasehat Tbk. bertanggung jawab penuh atas informasi yang tertera didalam dokumen ini. Perseroan menyampaikan Laporan Bulanan Registrasi Pemegang Efek yang berakhir pada 31 Maret 2026 Sebagai Berikut : Biro Administrasi Efek: PT. Adimitra Jasa Korpora
Page 2
Persen
Jumlah Persen
Jumlah Saham Saham Afiliasi Afiliasi Pemilik
Nama Alamat Jabatan Saham Bulan Saham Bulan Pengendali
Sebelumnya Sebelumny Pengendali Manfaat
Ini Ini
a
Ir. Rustiyan Jakarta, Direksi 181.661.600 1,31% 181.661.600 1,31%
Oen, MBA Indonesia X
Jozef Jakarta, Komisaris 978.000 0,01% 978.000 0,01%
Darmawan Indonesia X
Shinta Indonesia Komisaris 0 0% 0 0%
Pemegang Deviyanti X
Saham
Isje Ayusari Indonesia Komisaris 0 0% 0 0%
Direksi dan X
Komisaris
I Gusti Gede Indonesia Komisaris 0 0% 0 0%
Subawa
Joyce Indonesia Direksi 0 0% 0 0%
Vidyayanti
Nurvantina Indonesia Komisaris 0 0% 0 0%
Pandina
Christina Dian Indonesia Direksi 0 0% 0 0%
Anggraeni
Persen
Jumlah Persen
Jumlah Saham Saham Afiliasi Afiliasi Pemilik
Nama Alamat Saham Bulan Saham Bulan Pengendali
Pemegang Sebelumnya Sebelumny Pengendali Manfaat
Ini Ini
saham 5% a
(lima persen) PT Griyainsani Jl. Letjen. 8.991.740.800 64,65% 8.991.740.80 64,65%
atau lebih Cakrasadaya Suprapto Kav 0
X
4Jakarta Pusat
10510
Pemegang Saham < 5%
0 0% 0 0%
Publik - Warkat
4.733.101.10 34,03% 4.732.270. 34,025%
Publik - Non Warkat 0 400
Page 3
0 0% 830.700 0.005%
Saham Treasuri
13.907.481.5 100% 13.907.481.5 100%
Total 00 00
Page 4
Informasi Saham Free Float
Keterangan Bulan Sebelumnya Bulan Ini
Jumlah saham non-warkat dimiliki oleh seluruh pemegang
4.915.740.700 4.915.740.700
saham kurang dari 5%
Jumlah saham non-warkat dimiliki oleh Direksi dan Dewan
182.639.600 182.639.600
Komisaris kurang dari 5%
Jumlah saham non-warkat dimiliki oleh Pengendali kurang dari 5% 0 0
Jumlah saham non-warkat dimiliki oleh Afiliasi dari Pengendali 2.419.181.800 2.419.181.800
kurang dari 5%
Jumlah saham tresuri non-warkat kurang dari 5% 0 830.700
Jumlah saham non-warkat yang harus dibatasi pengalihan
kepemilikannya (lock up) baik berdasarkan Peraturan maupun 0 0
bagian tindakan korporasi Perusahaan Tercatat kurang dari 5%
Jumlah saham non-warkat dimiliki oleh Perusahaan Modal 0
0
Ventura dan Private Equity kurang dari 5%
Jumlah saham non-warkat yang berada dalam status sita atau
blokir oleh Aparat Penegak Hukum atau Otoritas yang 0 0
berwenang kurang dari 5%
Jumlah saham dengan penerima manfaat investor publik yang telah
disetujui Bursa untuk diperhitungkan sebagai Free Float (Ketentuan 0 0
V.2 Peraturan I-A dan Ketentuan V.2 Peraturan I-V)
Jumlah saham Free Float 2.313.919.300 2.313.088.600
Jumlah saham tercatat di Bursa per akhir bulan 13.907.481.500 13.907.481.500
% Saham Free Float 16,64 16,63
Page 5
Persentase Bulan
Keterangan Bulan Sebelumnya Bulan Ini Persentase Bulan Ini
Sebelumnya
Jumlah saham tidak tercatat 0 0% 0 0%
Jumlah Pemegang Saham Nasabah Pemilik SID
Bulan Sebelumnya Bulan Sekarang Perubahan
5.897 6.280 383
Pemilik manfaat yang terdiri dari satu pihak atau kelompok yang terorganisasi dari PT Mitra Keluarga
Karyasehat Tbk.
Pemegang Saham
Nomor Nama Langsung
Perseroan
1 Poppy Hadiman Setiawan Tidak
2 Gerda Veronica Tidak
3 Franciscus Bing Aryanto Tidak
4 Theresia Harsini Tidak
5 Maria Karmila Tidak
6 Rustiyan Oen Ya
7 Santoso Oen Tidak
Pemilik Manfaat dari Pemegang Saham lebih dari 10%
Page 6
Demikian untuk diketahui.
Hormat Kami,
PT Mitra Keluarga Karyasehat Tbk.
Joyce V. Handajani
Corporate Secretary
PT Mitra Keluarga Karyasehat Tbk.
Jl. Raya Gading Kirana Kav.2 Jakarta Utara 14240
Telepon : (021) 4585 2700, Fax : (021) 4585 2727, http://www.mitrakeluarga.com/
Nama Pengirim Joyce V. Handajani
Jabatan Corporate Secretary
Tanggal dan Waktu 09-04-2026 10:23
Lampiran 1. 3. MIKA - LAPORAN BULAN MARET 2026.pdf
Dokumen ini merupakan dokumen resmi PT Mitra Keluarga Karyasehat Tbk. yang tidak memerlukan tanda tangan
karena dihasilkan secara elektronik oleh sistem pelaporan elektronik. PT Mitra Keluarga Karyasehat Tbk.
bertanggung jawab penuh atas informasi yang tertera didalam dokumen ini.
Page 7
Go To Indonesian Page Letter / Announcement No. 22/MIKA-IV/2026 Issuer Name PT Mitra Keluarga Karyasehat Tbk. Issuer Code MIKA Listing Board Main Attachment 1 Subject Monthly Report of Securities Holders Registration Hereby, the Company declares that: 1. It is responsible for the preparation and presentation of the Monthly Securities Holder Registration Report. 2. All information contained in the LBRE has been fully and accurately disclosed, does not contain any incorrect material information or facts, and does not omit any material information or facts. 3. The Free Float calculation has been presented in accordance with Exchange Regulation Number I-A concerning the Listing of Shares and Equity Securities Other Than Shares Issued by Listed Companies, including the exclusion of share ownership by the Controlling Shareholder and its Affiliates; affiliates of beneficial owner; members of the Board of Commissioners or the Board of Directors; and treasury shares repurchased by the Company. The Board of Directors of PT Mitra Keluarga Karyasehat Tbk., on behalf of the Company, bears full responsibility for the information contained in this document. The Company hereby announce Monthly Report of Securities Holders Registration which ends in 31 March 2026 as follows: Security Administration Bureau: PT. Adimitra Jasa Korpora
Page 8
Number of Percent of Number of Percent of Affiliate of
Affiliate of the
Name Address Position Shares in Shares in Shares in Shares in Controller the
Beneficial Owner
Previous Previous Current Current Controller
Ir. Rustiyan Jakarta, Direksi 181,661,600 1.31% 181,661,600 1.31%
Oen, MBA Indonesia X
Jozef Jakarta, Komisaris 978,000 0.01% 978,000 0.01%
Darmawan Indonesia X
Board of Shinta Indonesia Komisaris 0 0% 0 0%
Deviyanti X
Directors and
Board of Isje Ayusari Indonesia Komisaris 0 0% 0 0%
Commission X
ers
I Gusti Gede Indonesia Komisaris 0 0% 0 0%
Subawa
Joyce Indonesia Direksi 0 0% 0 0%
Vidyayanti
Nurvantina Indonesia Komisaris 0 0% 0 0%
Pandina
Christina Dian Indonesia Direksi 0 0% 0 0%
Anggraeni
Number of Percent of Number of Percent of Affiliate of
Affiliate of the
Shareholders Name Address Shares in Shares in Shares in Shares in Controller the
Beneficial Owner
of 5% (five Previous Previous Current Current Controller
percent) or PT Griyainsani Jl. Letjen. 8,991,740,800 64.65% 8,991,740,80 64.65%
more Cakrasadaya Suprapto Kav 0
X
4Jakarta
Pusat 10510
0 0% 0 0%
Public - Scrip
4.733.101.10 34,03% 4.732.270. 34,025%
Public - Scripless 0 400
0 0% 830.700 0.005%
Treasury Stock
13.907.481.5 100% 13.907.481.5 100%
Total 00 00
Page 9
Free Float Share Information
Information Previous Month This Month
The number of scripless shares owned by shareholders is less
4.915.740.700 4.915.740.700
than 5%
The number of scripless shares owned by the Board of Directors
182.639.600 182.639.600
and Board of Commissioners is less than 5%
The number of scripless shares owned by the Controller is less
0 0
than 5%
The number of scripless shares owned by Affiliates of the 2.419.181.800 2.419.181.800
Controller is less than 5%
The amount of scripless treasury stock is less than 5% 0 830.700
The number of scripless shares owned less than 5% and subject
to a lock-up restriction, either based on regulations or the 0 0
corporate actions of the listed company.
The number of scripless shares owned less than 5% by venture
0 0
capital and private equity companies
The number of scripless shares owned less than 5% and subject
to confiscation or blocking by law enforcement officials or 0 0
authorized authorities.
Number of shares with public investor beneficiaries that have
been approved by IDX as Free Float (Provision V.2 of Regulation 0 0
I-A and Provision V.2 )
The amount of Free Float Share 2.313.919.300 2.313.088.600
The number of shares listed on the Exchange at the end of the
13.907.481.500 13.907.481.500
month
% Free Float Share 16,64 16,63
Page 10
Remarks Previous Month Previous Month Percentage Current Month Current Month Percentage
Number of Unlisted Shares 0 0% 0 0%
Number of Shareholders Holding SID Accounts
Previous Month Current Month Change
5.897 6.280 383
Beneficial owner consisting of one party or an organized group from PT Mitra Keluarga Karyasehat Tbk.
Company’s Direct
Number Name
Shareholders
1 Poppy Hadiman Setiawan Tidak
2 Gerda Veronica Tidak
3 Franciscus Bing Aryanto Tidak
4 Theresia Harsini Tidak
5 Maria Karmila Tidak
6 Rustiyan Oen Ya
7 Santoso Oen Tidak
Beneficial Owner of Shareholders more than 10%
Page 11
Thus to be informed accordingly.
Respectfully,
PT Mitra Keluarga Karyasehat Tbk.
Joyce V. Handajani
Corporate Secretary
PT Mitra Keluarga Karyasehat Tbk.
Jl. Raya Gading Kirana Kav.2 Jakarta Utara 14240
Phone : (021) 4585 2700, Fax : (021) 4585 2727, http://www.mitrakeluarga.com/
Sender Name Joyce V. Handajani
Function Corporate Secretary
Date and Time 09-04-2026 10:23
Attachment 1. 3. MIKA - LAPORAN BULAN MARET 2026.pdf
This is an official document of PT Mitra Keluarga Karyasehat Tbk. that does not require a signature as it was
generated electronically by the electronic reporting system. PT Mitra Keluarga Karyasehat Tbk. is fully responsible
for the information contained within this document.
Names mentioned 19 people and organisations named in the text · linked when the evidence is strong
unresolved
org
PT. Adimitra Jasa Korpora
· Biro Administrasi Efek
p.1 ×2
unresolved
person
Ir. Rustiyan
p.2 ×2
unresolved
person
Oen
p.2 ×2
unresolved
org
PT Griyainsani
p.2 ×2
unresolved
—
Poppy Hadiman Setiawan
p.5
unresolved
—
Gerda Veronica
p.5
unresolved
—
Franciscus Bing Aryanto
p.5
unresolved
—
Theresia Harsini
p.5
unresolved
—
Maria Karmila
p.5
unresolved
person
Joyce V. Handajani
· Corporate Secretary
p.6 ×2
unresolved
—
Jozef
· Komisaris
p.8
unresolved
—
I Gusti Gede
· Komisaris
p.8
unresolved
—
Joyce
· Direksi
p.8
unresolved
—
Nurvantina
· Komisaris
p.8
unresolved
—
Christina Dian
· Direksi
p.8
Extraction attempts how the parser did, and what it refused
Nothing structured was extracted from this document — the attempts below say why.
Rule parser
OK
confidence 0.900
473 ms
12 Sep 2026 22:29
Raw output
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'treasury': {'pct': '5', 'shares': '830700'},
'under5_non_warkat': {'pct': '34.025', 'shares': '4732270400'},
'under5_warkat': {'pct': '0', 'shares': '0'}},
'as_of_date': '2026-03-31',
'checksum_ok': True,
'checksum_parts': '13907481500',
'holders': [{'address': 'Jakarta, Indonesia',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': True,
'name': 'Rustiyan Oen, MBA',
'page_no': 2,
'pct': '1.31',
'pct_prev': '1.31',
'position': 'Direksi',
'seq': 0,
'shares': '181661600',
'shares_prev': '181661600'},
{'address': 'Jakarta, Indonesia',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': True,
'name': 'Jozef Darmawan',
'page_no': 2,
'pct': '0.01',
'pct_prev': '0.01',
'position': 'Komisaris',
'seq': 1,
'shares': '978000',
'shares_prev': '978000'},
{'address': 'Indonesia',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': True,
'name': 'Shinta Deviyanti',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Komisaris',
'seq': 2,
'shares': '0',
'shares_prev': '0'},
{'address': 'Indonesia',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': True,
'name': 'Isje Ayusari',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Komisaris',
'seq': 3,
'shares': '0',
'shares_prev': '0'},
{'address': 'Indonesia',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'Gusti Gede Subawa',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Komisaris',
'seq': 4,
'shares': '0',
'shares_prev': '0'},
{'address': 'Indonesia',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'Joyce Vidyayanti',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Direksi',
'seq': 5,
'shares': '0',
'shares_prev': '0'},
{'address': 'Indonesia',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'Nurvantina Pandina',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Komisaris',
'seq': 6,
'shares': '0',
'shares_prev': '0'},
{'address': 'Indonesia',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'Christina Dian Anggraeni',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Direksi',
'seq': 7,
'shares': '0',
'shares_prev': '0'},
{'address': 'Jl. Letjen. Suprapto Kav 4Jakarta Pusat 10510',
'category': 'FIVE_PCT',
'is_controller': True,
'is_controller_affiliate': False,
'name': 'Griyainsani Cakrasadaya',
'page_no': 2,
'pct': '64.65',
'pct_prev': '64.65',
'position': '',
'seq': 8,
'shares': '8991740800',
'shares_prev': '8991740800'}],
'issuer_name': 'PT Mitra Keluarga Karyasehat Tbk.',
'issuer_ticker': 'MIKA',
'layout': 'EREP_COVER',
'letter_number': '22/MIKA-IV/2026',
'listing_board': 'Utama',
'period_label': 'Maret 2026',
'registrar': 'PT. Adimitra Jasa Korpora',
'total_shares': '13907481500'}