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20231205_MEDS_Laporan Bulanan Registrasi Pemegang Efek//Perubahan Struktur Pemegang Saham_31545577.pdf
Shareholder register Parsed MEDSSource file signed link, expires in 15 minutes
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Page 1
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Nomor Surat 001/SPE/HMI/XII/2023
Nama Perusahaan PT Hetzer Medical Indonesia Tbk
Kode Emiten MEDS
Papan Pencatatan Pengembangan
Lampiran 1
Perihal Laporan Bulanan Registrasi Pemegang Efek
Perseroan menyampaikan Laporan Bulanan Registrasi Pemegang Efek yang berakhir pada 30 November 2023
Sebagai Berikut :
Biro Administrasi Efek: PT. Sinartama Gunita
Persen
Jumlah Persen
Jumlah Saham Saham
Nama Alamat Jabatan Saham Bulan Saham Bulan Pengendali Afiliasi
Sebelumnya Sebelumny
Ini Ini
a
Jemmy Kompleks Blue Komisaris 562.500.000 36% 562.500.000 36%
Kurniawan Sky Industrial X
(BSI) Kav
No.09, Jl.
Nanjung No. 2
RT 03 RW 05,
Kel.
Leuwigajah,
Pemegang Kec. Cimahi
Selatan, Kota
Saham > 5%
Cimahi, Jawa
Franciscus Kompleks Blue Komisaris 437.500.000 28% 437.500.000 28%
Rijadi Sky Industrial
(BSI) Kav
No.09, Jl.
Nanjung No. 2
RT 03 RW 05,
Kel.
Leuwigajah,
Kec. Cimahi
Selatan, Kota
Cimahi, Jawa
Page 2
Persen
Jumlah Persen
Jumlah Saham Saham
Nama Alamat Jabatan Saham Bulan Saham Bulan Pengendali Afiliasi
Sebelumnya Sebelumny
Ini Ini
a
Tato Suprapto Kompleks Blue Komisaris 0 0% 0 0%
Basir Sky Industrial
(BSI) Kav
No.09, Jl.
Nanjung No. 2
RT 03 RW 05,
Kel.
Leuwigajah,
Kec. Cimahi
Selatan, Kota
Cimahi, Jawa
A. Padmono Kompleks Blue Direksi 62.500.000 4% 62.500.000 4%
Budi Sanyoto Sky Industrial
(BSI) Kav
No.09, Jl.
Nanjung No. 2
RT 03 RW 05,
Kel.
Leuwigajah,
Pemegang
Kec. Cimahi
Saham > 5%
Selatan, Kota
Cimahi, Jawa
Fancy Kompleks Blue Direksi 62.500.000 4% 62.500.000 4%
Marsiana Sky Industrial
(BSI) Kav
No.09, Jl.
Nanjung No. 2
RT 03 RW 05,
Kel.
Leuwigajah,
Kec. Cimahi
Selatan, Kota
Cimahi, Jawa
Page 3
Persen
Jumlah Persen
Jumlah Saham Saham
Nama Alamat Jabatan Saham Bulan Saham Bulan Pengendali Afiliasi
Sebelumnya Sebelumny
Ini Ini
a
Herry Kompleks Blue Direksi 1.716.100 0,11% 1.716.100 0,11%
Sky Industrial
Pemegang (BSI) Kav
No.09, Jl.
Saham > 5%
Nanjung No. 2
RT 03 RW 05,
Kel.
Leuwigajah,
Kec. Cimahi
Selatan, Kota
Cimahi, Jawa
0 0% 0 0%
Masyarakat - Warkat - Scrip
435.783.900 27,89% 435.783.90 27,89%
Masyarakat - Non Warkat - Scripless 0
0 0% 0 0%
Saham Treasury
1.562.500.00 100% 1.562.500.00 100%
Total 0 0
Persentase Jumlah Saham (Bulan Persentase(Bulan
Nama Jumlah Saham (Sebelumnya)
(Sebelumnya) Ini) Ini)
562,500,000 36% 562,500,000 36%
Total Pengendali
1,000,000,000 64% 1,000,000,000 64%
Total Non Pengendali
Page 4
Informasi Saham Free Float
Keterangan Bulan Sebelumnya Bulan Ini
Jumlah saham scripless dimiliki oleh pemegang saham kurang
562.500.000 562.500.000
dari 5%
Jumlah saham scripless dimiliki oleh Direksi dan Dewan
126.716.100 126.716.100
Komisaris kurang dari 5%
Jumlah saham scripless dimiliki oleh Pengendali kurang dari 5% 0 0
Jumlah saham scripless dimiliki oleh Afiliasi dari Pengendali 0 0
kurang dari 5%
Jumlah treasury stock scripless kurang dari 5% 0 0
Jumlah saham portofolio investasi dengan penerima manfaat
0 0
investor publik yang telah disetujui Bursa untuk diperhitungkan
sebagai Free Float
Jumlah saham Free Float 435.783.900 435.783.900
Jumlah saham tercatat di Bursa per akhir bulan 1.562.500.000 1.562.500.000
% Saham Free Float 27,89 27,89
Jumlah Pemegang Saham
Bulan Sebelumnya Bulan Sekarang Perubahan
6.681 6.462 219
Penerima Manfaat Akhir dari Kepemilikan Saham
Page 5
Nomor Nama
1 JEMMY KURNIAWAN
Demikian untuk diketahui.
Hormat Kami,
PT Hetzer Medical Indonesia Tbk
A. Padmono Budi Sanyoto
Direktur Utama
PT Hetzer Medical Indonesia Tbk
Kompleks Blue Sky Industrial (BSI) Kav No.09, Jl. Nanjung No. 2 RT 03 RW 05, Kel.
Telepon : +62 22 6679409, +62 22 6679383, Fax : +62 22 6613426, https://www.
Nama Pengirim A. Padmono Budi Sanyoto
Jabatan Direktur Utama
Tanggal dan Waktu 06-12-2023 15:02
Lampiran 1. Laporan Bulanan MEDS per November 2023.pdf
Dokumen ini merupakan dokumen resmi PT Hetzer Medical Indonesia Tbk yang tidak memerlukan tanda tangan
karena dihasilkan secara elektronik oleh sistem pelaporan elektronik. PT Hetzer Medical Indonesia Tbk bertanggung
jawab penuh atas informasi yang tertera didalam dokumen ini.
Page 6
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Letter / Announcement No. 001/SPE/HMI/XII/2023
Issuer Name PT Hetzer Medical Indonesia Tbk
Issuer Code MEDS
Listing Board Development
Attachment 1
Subject Monthly Report of Securities Holders Registration
The Company hereby announce Monthly Report of Securities Holders Registration which ends in 30 November
2023 as follows:
Security Administration Bureau: PT. Sinartama Gunita
Number of Percent of Number of Percent of
Name Address Position Shares in Shares in Shares in Shares in Controller Affiliation
Previous Previous Current Current
Jemmy Kompleks Blue Komisaris 562,500,000 36% 562,500,000 36%
Kurniawan Sky Industrial X
(BSI) Kav
No.09, Jl.
Nanjung No. 2
RT 03 RW 05,
Kel.
Leuwigajah,
Kec. Cimahi
Share Selatan, Kota
Ownership > Cimahi, Jawa
5% Franciscus Kompleks Blue Komisaris 437,500,000 28% 437,500,000 28%
Rijadi Sky Industrial
(BSI) Kav
No.09, Jl.
Nanjung No. 2
RT 03 RW 05,
Kel.
Leuwigajah,
Kec. Cimahi
Selatan, Kota
Cimahi, Jawa
Page 7
Number of Percent of Number of Percent of
Name Address Position Shares in Shares in Shares in Shares in Controller Affiliation
Previous Previous Current Current
Tato Suprapto Kompleks Blue Komisaris 0 0% 0 0%
Basir Sky Industrial
(BSI) Kav
No.09, Jl.
Nanjung No. 2
RT 03 RW 05,
Kel.
Leuwigajah,
Kec. Cimahi
Selatan, Kota
Cimahi, Jawa
A. Padmono Kompleks Blue Direksi 62,500,000 4% 62,500,000 4%
Budi Sanyoto Sky Industrial
(BSI) Kav
No.09, Jl.
Nanjung No. 2
RT 03 RW 05,
Kel.
Share Leuwigajah,
Ownership > Kec. Cimahi
5% Selatan, Kota
Cimahi, Jawa
Fancy Kompleks Blue Direksi 62,500,000 4% 62,500,000 4%
Marsiana Sky Industrial
(BSI) Kav
No.09, Jl.
Nanjung No. 2
RT 03 RW 05,
Kel.
Leuwigajah,
Kec. Cimahi
Selatan, Kota
Cimahi, Jawa
Herry Kompleks Blue Direksi 1,716,100 0.11% 1,716,100 0.11%
Sky Industrial
(BSI) Kav
No.09, Jl.
Nanjung No. 2
RT 03 RW 05,
Kel.
Leuwigajah,
Kec. Cimahi
Selatan, Kota
Cimahi, Jawa
Page 8
0 0% 0 0%
Masyarakat - Warkat - Scrip
435.783.900 27,89% 435.783.90 27,89%
Masyarakat - Non Warkat - Scripless 0
0 0% 0 0%
Saham Treasury
1.562.500.00 100% 1.562.500.00 100%
Total 0 0
Percentage Number of Shares (This Percentage (This
Name Number of Shares (Previously)
(Previous) Month) Month)
562,500,000 36% 562,500,000 36%
Total Controller
1,000,000,000 64% 1,000,000,000 64%
Total Non-Controllers
Page 9
Free Float Share Information
Information Previous Month This Month
The number of scripless shares owned by shareholders is less
562.500.000 562.500.000
than 5%
The number of scripless shares owned by the Board of Directors
126.716.100 126.716.100
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 0 0
Controller is less than 5%
The amount of scripless treasury stock is less than 5% 0 0
Number of investment portfolio shares with public investor
0 0
beneficiaries that have been approved by the Exchange to be
counted as Free Float
The amount of Free Float Share 435.783.900 435.783.900
The number of shares listed on the Exchange at the end of the
1.562.500.000 1.562.500.000
month
% Free Float Share 27,89 27,89
Number of Shareholders
Previous Month This Month Change
6.681 6.462 219
Final Beneficiaries of Share Ownership
Page 10
Number Name
1 JEMMY KURNIAWAN
Thus to be informed accordingly.
Respectfully,
PT Hetzer Medical Indonesia Tbk
A. Padmono Budi Sanyoto
Direktur Utama
PT Hetzer Medical Indonesia Tbk
Kompleks Blue Sky Industrial (BSI) Kav No.09, Jl. Nanjung No. 2 RT 03 RW 05, Kel.
Phone : +62 22 6679409, +62 22 6679383, Fax : +62 22 6613426, https://www.
Sender Name A. Padmono Budi Sanyoto
Function Direktur Utama
Date and Time 06-12-2023 15:02
Attachment 1. Laporan Bulanan MEDS per November 2023.pdf
This is an official document of PT Hetzer Medical Indonesia Tbk that does not require a signature as it was
generated electronically by the electronic reporting system. PT Hetzer Medical Indonesia Tbk is fully responsible for
the information contained within this document.
Names mentioned 0 people and organisations named in the text · linked when the evidence is strong
The name pass has not read this document yet.
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
174 ms
12 Sep 2026 21:50
Raw output
{'aggregates': {'total': {'pct': '100', 'shares': '1562500000'},
'treasury': {'pct': '0', 'shares': '0'},
'under5_non_warkat': {'pct': '27.89', 'shares': '435783900'},
'under5_warkat': {'pct': '0', 'shares': '0'}},
'as_of_date': '2023-11-30',
'checksum_ok': True,
'checksum_parts': '1562500000',
'holders': [{'address': 'Kompleks Blue Sky Industrial (BSI) Kav No.09, Jl. '
'Nanjung No. 2 RT 03 RW 05,',
'category': 'BOARD',
'is_controller': True,
'is_controller_affiliate': False,
'name': 'Jemmy Kurniawan',
'page_no': 1,
'pct': '36',
'pct_prev': '36',
'position': 'Komisaris',
'seq': 0,
'shares': '562500000',
'shares_prev': '562500000'},
{'address': 'Kel. Leuwigajah, Kec. Cimahi Selatan, Kota Cimahi, '
'Jawa Kompleks Blue Sky Industrial',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'Franciscus Rijadi',
'page_no': 1,
'pct': '28',
'pct_prev': '28',
'position': 'Komisaris',
'seq': 1,
'shares': '437500000',
'shares_prev': '437500000'},
{'address': 'Kompleks Blue Sky Industrial (BSI) Kav No.09, Jl. '
'Nanjung No. 2 RT 03 RW 05,',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'Tato Suprapto Basir',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Komisaris',
'seq': 2,
'shares': '0',
'shares_prev': '0'},
{'address': 'Kel. Leuwigajah, Kec. Cimahi Selatan, Kota Cimahi, '
'Jawa Kompleks Blue Sky Industrial (BSI) Kav No.09, '
'Jl. Nanjung No. 2 RT 03 RW 05,',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'Padmono Budi Sanyoto',
'page_no': 2,
'pct': '4',
'pct_prev': '4',
'position': 'Direksi',
'seq': 3,
'shares': '62500000',
'shares_prev': '62500000'},
{'address': 'Kel. Leuwigajah, Kec. Cimahi Selatan, Kota Cimahi, '
'Jawa Kompleks Blue Sky Industrial',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'Fancy Marsiana',
'page_no': 2,
'pct': '4',
'pct_prev': '4',
'position': 'Direksi',
'seq': 4,
'shares': '62500000',
'shares_prev': '62500000'},
{'address': 'Kompleks Blue Sky Industrial',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'Herry',
'page_no': 3,
'pct': '0.11',
'pct_prev': '0.11',
'position': 'Direksi',
'seq': 5,
'shares': '1716100',
'shares_prev': '1716100'}],
'issuer_name': 'PT Hetzer Medical Indonesia Tbk',
'issuer_ticker': 'MEDS',
'layout': 'EREP_COVER',
'letter_number': '001/SPE/HMI/XII/2023',
'listing_board': 'Pengembangan',
'period_label': 'November 2023',
'registrar': 'PT. Sinartama Gunita',
'total_shares': '1562500000'}