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20230907_FMII_Laporan Bulanan Registrasi Pemegang Efek//Perubahan Struktur Pemegang Saham_31407571.pdf
Shareholder register Parsed FMIISource file signed link, expires in 15 minutes
Extracted text 10
Page 1
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Nomor Surat 61/FMI-CS/IX/2023
Nama Perusahaan Fortune Mate Indonesia Tbk
Kode Emiten FMII
Papan Pencatatan Pengembangan
Lampiran 1
Perihal Laporan Bulanan Registrasi Pemegang Efek
Perseroan menyampaikan Laporan Bulanan Registrasi Pemegang Efek yang berakhir pada 31 Agustus 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
Masyarakat jawa timur 378.511.213 12,13% 378.511.213 12,13%
PT Surya Jl. Tambak 1.456.696.066 46,67% 1.456.696.06 46,67%
Mega Sawah No:6 6 X X
Blok A19, Lantai
1 Kec. Waru.
Pemegang
Sidoarjo
Saham > 5% Tjandra Gedung Gozco Direksi 642.896.177 20,6% 642.896.177 20,6%
Mindharta Lt. 3 Jl. Raya X X
Darmo No. 54-
56, Surabaya
60265 Jawa
Timur
Teddy Romokalisari Komisaris 642.896.177 20,6% 642.896.177 20,6%
Gunawan RT 1/RW1, X X
Romokalisari,
Benowo,
Surabaya
0 0% 0 0%
Masyarakat - Warkat - Scrip
Page 2
0 0% 0 0%
Masyarakat - Non Warkat - Scripless
0 0% 0 0%
Saham Treasury
3.120.999.63 100% 3.120.999.63 100%
Total 3 3
Persentase Jumlah Saham (Bulan Persentase(Bulan
Nama Jumlah Saham (Sebelumnya)
(Sebelumnya) Ini) Ini)
2,742,488,420 87.87% 2,742,488,420 87.87%
Total Pengendali
378,511,213 12.13% 378,511,213 12.13%
Total Non Pengendali
Page 3
Informasi Saham Free Float
Keterangan Bulan Sebelumnya Bulan Ini
Jumlah saham scripless dimiliki oleh pemegang saham kurang
378.511.213 378.511.213
dari 5%
Jumlah saham scripless dimiliki oleh Direksi dan Dewan
0 0
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 378.511.213 378.511.213
Jumlah saham tercatat di Bursa per akhir bulan 0 0
% Saham Free Float 378.511.213 378.511.213
Jumlah Pemegang Saham
Bulan Sebelumnya Bulan Sekarang Perubahan
928 899 29
Penerima Manfaat Akhir dari Kepemilikan Saham
Page 4
Nomor Nama
1 Teddy Gunawan
2 Tjandra Mindharta Gozali
Pengendali dari Pemegang Saham Pengendali dalam bentuk perseroan Terbatas
Nomor Nama Alamat Jumlah Saham
1 PT Surya Mega Investindo Jl. Tambak Sawah No:6 Blok A19, 1.456.696.066
Lantai 1 Kec. Waru. Sidoarjo
Demikian untuk diketahui.
Hormat Kami,
Fortune Mate Indonesia Tbk
Agustinus Agus Sunarto
Corporate Secretary
Fortune Mate Indonesia Tbk
Gedung Gozco Lt. 3 Jl. Raya Darmo No. 54-56, Surabaya 60265 Jawa Timur
Telepon : (031) 561-28-18 (hunting) , Fax : (031) 562-09-68 , www.fmiindo.com
Nama Pengirim Agustinus Agus Sunarto
Jabatan Corporate Secretary
Page 5
Tanggal dan Waktu 07-09-2023 11:39
Lampiran 1. DPS FMII AGUSTUS 2023.pdf
Dokumen ini merupakan dokumen resmi Fortune Mate Indonesia Tbk yang tidak memerlukan tanda tangan karena
dihasilkan secara elektronik oleh sistem pelaporan elektronik. Fortune Mate Indonesia Tbk bertanggung jawab
penuh atas informasi yang tertera didalam dokumen ini.
Page 6
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Letter / Announcement No. 61/FMI-CS/IX/2023
Issuer Name Fortune Mate Indonesia Tbk
Issuer Code FMII
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 31 August
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
Masyarakat jawa timur 378,511,213 12.13% 378,511,213 12.13%
PT Surya Jl. Tambak 1,456,696,066 46.67% 1,456,696,06 46.67%
Mega Sawah No:6 6 X X
Blok A19, Lantai
Share 1 Kec. Waru.
Ownership > Sidoarjo
5% Tjandra Gedung Gozco Direksi 642,896,177 20.6% 642,896,177 20.6%
Mindharta Lt. 3 Jl. Raya X X
Darmo No. 54-
56, Surabaya
60265 Jawa
Timur
Teddy Romokalisari Komisaris 642,896,177 20.6% 642,896,177 20.6%
Gunawan RT 1/RW1, X X
Romokalisari,
Benowo,
Surabaya
0 0% 0 0%
Masyarakat - Warkat - Scrip
0 0% 0 0%
Masyarakat - Non Warkat - Scripless
Page 7
0 0% 0 0%
Saham Treasury
3.120.999.63 100% 3.120.999.63 100%
Total 3 3
Percentage Number of Shares (This Percentage (This
Name Number of Shares (Previously)
(Previous) Month) Month)
2,742,488,420 87.87% 2,742,488,420 87.87%
Total Controller
378,511,213 12.13% 378,511,213 12.13%
Total Non-Controllers
Page 8
Free Float Share Information
Information Previous Month This Month
The number of scripless shares owned by shareholders is less
378.511.213 378.511.213
than 5%
The number of scripless shares owned by the Board of Directors
0 0
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 378.511.213 378.511.213
The number of shares listed on the Exchange at the end of the
0 0
month
% Free Float Share 378.511.213 378.511.213
Number of Shareholders
Previous Month This Month Change
928 899 29
Final Beneficiaries of Share Ownership
Page 9
Number Name
1 Teddy Gunawan
2 Tjandra Mindharta Gozali
Controlling from the Controlling Shareholder in the form of a Limited Liability Company
Number Name Address Total Stock
1 PT Surya Mega Investindo Jl. Tambak Sawah No:6 Blok A19, 1,456,696,066
Lantai 1 Kec. Waru. Sidoarjo
Thus to be informed accordingly.
Respectfully,
Fortune Mate Indonesia Tbk
Agustinus Agus Sunarto
Corporate Secretary
Fortune Mate Indonesia Tbk
Gedung Gozco Lt. 3 Jl. Raya Darmo No. 54-56, Surabaya 60265 Jawa Timur
Phone : (031) 561-28-18 (hunting) , Fax : (031) 562-09-68 , www.fmiindo.com
Sender Name Agustinus Agus Sunarto
Function Corporate Secretary
Page 10
Date and Time 07-09-2023 11:39
Attachment 1. DPS FMII AGUSTUS 2023.pdf
This is an official document of Fortune Mate Indonesia Tbk that does not require a signature as it was generated
electronically by the electronic reporting system. Fortune Mate 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
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Rule parser
OK
confidence 0.900
82 ms
12 Sep 2026 22:04
Raw output
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'treasury': {'pct': '0', 'shares': '0'},
'under5_non_warkat': {'pct': '0', 'shares': '0'},
'under5_warkat': {'pct': '0', 'shares': '0'}},
'as_of_date': '2023-08-31',
'checksum_ok': True,
'checksum_parts': '3120999633',
'holders': [{'address': 'jawa timur',
'category': 'FIVE_PCT',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'Masyarakat',
'page_no': 1,
'pct': '12.13',
'pct_prev': '12.13',
'position': '',
'seq': 0,
'shares': '378511213',
'shares_prev': '378511213'},
{'address': 'Jl. Tambak Sawah No:6 Blok A19, Lantai',
'category': 'FIVE_PCT',
'is_controller': True,
'is_controller_affiliate': True,
'name': 'PT Surya Mega',
'page_no': 1,
'pct': '46.67',
'pct_prev': '46.67',
'position': '',
'seq': 1,
'shares': '1456696066',
'shares_prev': '1456696066'},
{'address': '1 Kec. Waru. Sidoarjo Gedung Gozco Lt. 3 Jl. Raya '
'Darmo No. 54- 56, Surabaya',
'category': 'BOARD',
'is_controller': True,
'is_controller_affiliate': True,
'name': 'Tjandra Mindharta',
'page_no': 1,
'pct': '20.6',
'pct_prev': '20.6',
'position': 'Direksi',
'seq': 2,
'shares': '642896177',
'shares_prev': '642896177'},
{'address': '60265 Jawa Timur Romokalisari RT 1/RW1,',
'category': 'BOARD',
'is_controller': True,
'is_controller_affiliate': True,
'name': 'Teddy Gunawan',
'page_no': 1,
'pct': '20.6',
'pct_prev': '20.6',
'position': 'Komisaris',
'seq': 3,
'shares': '642896177',
'shares_prev': '642896177'}],
'issuer_name': 'Fortune Mate Indonesia Tbk',
'issuer_ticker': 'FMII',
'layout': 'EREP_COVER',
'letter_number': '61/FMI-CS/IX/2023',
'listing_board': 'Pengembangan',
'period_label': 'Agustus 2023',
'registrar': 'PT. Sinartama Gunita',
'total_shares': '3120999633'}