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Page 1 OCR 0.917
ts” PT. MEDIKALOKA HERMINA Tbk
Kantor Pusat : Jl. Raya Jatinegara Barat No. 126 Jatinegara, Jakarta Timur 13320
Kantor Cabang : Hermina Tower | Lt. 10 Jl. Selangit Blok B-10 Kav. 04, Kemayoran, Jakarta Pusat 10610
Telp. 021-8572525 Fax. 021-8560801 Website : www.herminahospitals.com
SURAT PERNYATAAN DIREKSI DIRECTORS' STATEMENT LETTER
TENTANG TANGGUNG JAWAB ATAS REGARDING THE RESPONSIBILITY FOR
LAPORAN KEUANGAN INTERIM KONSOLIDASIAN INTERIM CONSOLIDATED FINANCIAL STATEMENTS
TANGGAL 30 SEPTEMBER 2023 AS OF SEPTEMBER 30, 2023
DAN UNTUK PERIODE SEMBILAN BULAN YANG AND FOR THE NINE-MONTH PERIOD
BERAKHIR PADA TANGGAL TERSEBUT (Tidak Diaudit) THEN ENDED (Unaudited)
PT MEDIKALOKA HERMINA TBK (“PERUSAHAAN”) PT MEDIKALOKA HERMINA TBK (“THE COMPANY”)
DAN ENTITAS ANAKNYA AND ITS SUBSIDIARIES
Kami yang bertanda tangan di bawah ini: We, the undersigned:
Nama Hasmoro Name
Alamat kantor Jl. Selangit, Blok B. 10, Kav. 4, Kemayoran, Office address
Jakarta Pusat
Alamat domisili Tebet Barat I No. A-3 RT 009/002, Tebet, Residential address
Jakarta Selatan
Jabatan Direktur Utama/President Director Title
Nama Aristo S. Setiawidjaja Name
Alamat kantor Jl. Selangit, Blok B. 10, Kav. 4, Kemayoran, Office address
Jakarta Pusat
Alamat domisili Jl. Lautze Dalam No. 78 RT 001/006, Residential address
Sawah Besar Jakarta Pusat
Jabatan Direktur/Director Title
Menyatakan bahwa: Declare that:
1, Kami bertanggung jawab atas penyusunan dan 1. We are responsible for the preparation and
penyajian laporan keuangan interim konsolidasian presentation of the interim consolidated financial
Perusahaan dan Entitas Anaknya, statements of the Company and its Subsidiaries,
2. Laporan keuangan interim konsolidasian Perusahaan 2. The interim consolidated financial statements of the
dan Entitas Anaknya telah disusun dan disajikan Company and its Subsidiaries have been prepared and
sesuai dengan Standar Akuntansi Keuangan (“SAK”) presented in accordance with Indonesian Financial
di Indonesia, peraturan Otoritas Jasa Keuangan Accounting Standards ("SAK"), the Indonesian
("OJK"): dan Pedoman Penyajian dan Pengungkapan Financial Services Authority (“OJK") regulations, and
Laporan Emiten atau Perusahaan Publik yang Guidance for Presentation and Disclosure of Issuer of
dikeluarkan oleh OJK, the Report or Public Company released by OJK,
3. a. Semua informasi dalam laporan keuangan interim 3. 2 All information contained in the interim consolidated
konsolidasian Perusahaan dan Entitas Anaknya financial statements ofthe Company and its
telah dimuat secara lengkap dan benar, Subsidiaries have been completely and properiy
disclosed,
b. Laporan keuangan interim konsolidasian b. The interim consolidated financial statements of the
Perusahaan dan Entitas Anaknya tidak Company and its Subsidiaries do not contain any
mengandung informasi atau fakta material yang improper material information or facts and do not
tidak benar, dan tidak menghilangkan informasi omit material information or facts:
atau fakta material:
4. Kami bertanggung jawab atas sistem pengendalian — 4. We are responsible forthe intemal control system of the
internal dalam Perusahaan dan Entitas Anaknya. Company and its Subsidiaries.
Demikian pernyataan ini dibuat dengan sebenarnya. Thus, this statement is made truthfully.
Atas nama dan mewakili Dewan Direksi/For and on behalf of the Board of Directors
Jakarta, 17 Oktober 2023/ October 17, 2023
Hasmoro
Direktur Utama/President Director
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