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20231006_ASDM_Laporan Informasi dan Fakta Material_31436005_lamp1.pdf
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Page 1 OCR 0.921
Jakarta, 6 Oktober 2023
No. Ref.: B.075/CS/X/2023
Kepada Yth. / 70
Otoritas Jasa Keuangan (OJK)
Gedung Sumitro Djojohadikusumo
Jl. Lapangan Banteng Timur No. 2-4
Jakarta 10710
Up. Kepala Eksekutif Pengawas Pasar
Modal, Keuangan Derivatif, dan
Bursa Karbon
Perihal: Keterbukaan Informasi
Fakta Material
atau
Dengan hormat,
Dengan ini kami untuk dan atas nama PT
Asuransi Dayin Mitra Tbk (“Perseroan”),
menyampaikan Keterbukaan Informasi atau
Fakta Material berdasarkan Peraturan Otoritas
Jasa Keuangan Nomor 31/POJK.04/2015
tentang Keterbukaan Informasi atau Fakta
Material oleh Emiten atau Perusahaan Publik,
sebagai berikut:
Nama Emiten / Name of Issuer
Attn. Chief Executive functioning as
Capital Markets, Financial
Derivatives, and Carbon Exchange
Supervisor
Re. : Disclosure of Material Information
or Fact
Wiith due respect,
For and on behalf of PT Asuransi Dayin Mitra
Tbk ("the Company"), we hereby convey the
following Disclosure of Material Information or
Fact based on Financial Services Authority
Regulation — Number 31/POJK.04/2015
concerning Disclosure of Information or
Material Facts by Issuers or Public Companies,
as follows:
: PT Asuransi Dayin Mitra Tbk (ASDM)
Bidang Usaha / Scope of Business : Asuransi Umum Konvensional / General Insurance
Telepon / Telephone
Alamat surat elektronik / e-mail
: 021-80868888
: csecretary@dayinmitra.com
1. | Tanggal 4 Oktober 2023
Kejadian
1. | Date of Event | October 4, 2023
PT ASURANSI
DAYIN MITRA Tbk
WISMA HAYAM WURUK, 7" floor - Jl. Hayam Wuruk No. 8 - Jakarta 10120 - Indonesia
T. (62-21) 8086 8888 (Hunting) - Website : www.asuransidayinmitra.com
General
Insurance
Anggota AAUI No. 073.01041999.2.01
Page 2 OCR 0.916
Jenis Keterbukaan Informasi 2 | Typeof Information Informasi atau | terkait Komisaris Material disclosure regarding Fakta Material | Independen Perseroan Information the Companys meninggal dunia. or Fact Independent Commissioner — has passed away. Uraian Perseroan & | Description of| The Company herby Informasi atau | memberitahukan Material notify that on Fakta Material | bahwa pada Rabu, 4 Information or | Wednesday, October Oktober 2023, Bapak Fact 4, 2023, Mr. Abdul Abdul Salam selaku Salam as Komisaris Independen Independent Perseroan dan Ketua Commissioner — and Komite Audit telah Chairman of the Audit meninggal dunia. Committee of the Company has passed away. Dampak Tidak ada 4 | Impact of the| None kejadian, event or informasi atau material fakta material information or tersebut fact on the terhadap Operations, kegiatan legal matters, operasional, financial hukum, condition — or kondisi business keuangan, continuity of atau the Issuer or kelangsungan Public usaha Emiten Company atau Perusahaan Publik Keterangan Tidak ada 5. | Other None lain-lain information PT ASURANSI DAYIN MITRA Tbk General Insurance
Page 3 OCR 0.918
Demikian pemberitahuan ini kami sampaikan, Thus we convey this information. Thank you atas perhatiannya kami ucapkan terima kasih. for your kind attention. v 4 Hormat kami, / Best Regards, PT Asuransi Dayin Mitra Tbk da Purnama Hadiwidjaja Corporate Secretary PT ASURANSI DAYIN MITRA Tbk General Insurance
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