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20230804_OMED_Laporan Bulanan Registrasi Pemegang Efek//Perubahan Struktur Pemegang Saham_31357953.pdf
Shareholder register Parsed OMEDSource file signed link, expires in 15 minutes
Extracted text 8
Page 1
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Nomor Surat 054/DIR-JMI/VIII/23
Nama Perusahaan PT Jayamas Medica Industri Tbk
Kode Emiten OMED
Papan Pencatatan Utama
Lampiran 1
Perihal Laporan Bulanan Registrasi Pemegang Efek
Perseroan menyampaikan Laporan Bulanan Registrasi Pemegang Efek yang berakhir pada 31 Juli 2023 Sebagai
Berikut :
Biro Administrasi Efek: PT. Datindo Entrycom
Persen
Jumlah Persen
Jumlah Saham Saham
Nama Alamat Jabatan Saham Bulan Saham Bulan Pengendali Afiliasi
Sebelumnya Sebelumny
Ini Ini
a
Leonard
Jl. Tanjung Golf Direksi 0 0% 0 0%
Hariadi G.1-8,
Lakarsantri,
Surabaya
Louis Krisnadi Kencanasari Direksi 0 0% 0 0%
Hartanto Barat 1/A-4,
Surabaya
Eka Jl. Woodland Direksi 0 0% 0 0%
Suwignyoo WL 2 No 11,
Pemegang
Citraland,
Saham > 5% Surabaya
PT Intisumber Komplek Darmo 22.540.000.00 83,3% 22.540.000.0 83,3%
Hasilsempurn Park II Blok IV 0 00 X
no. 14-15,
Surabaya
Yacobus Kencanasari Komisaris 230.618.000 0,85% 230.000.000 0,85%
Jemmy Barat 1/A-4, X
Surabaya
Siane Kencanasari Komisaris 230.000.000 0,85% 230.000.000 0,85%
Soetanto Barat 1/A-4, X
Surabaya
Page 2
Persen
Jumlah Persen
Jumlah Saham Saham
Nama Alamat Jabatan Saham Bulan Saham Bulan Pengendali Afiliasi
Sebelumnya Sebelumny
Ini Ini
a
BRIGJEN Jl. Rantai Timah Komisaris 0 0% 0 0%
Pemegang (PURN) Dr. G-27, Jakarta
Saham > 5%
Dra. Herlien Jl. Ketintang Direksi 0 0% 0 0%
Sri Ariani, Selatan XII/17,
Karah,
Jambangan,
Surabaya
0 0% 0 0%
Masyarakat - Warkat - Scrip
4.058.232.00 15% 4.058.850. 15%
Masyarakat - Non Warkat - Scripless 0 000
0 0% 0 0%
Saham Treasury
27.058.850.0 100% 27.058.850.0 100%
Total 00 00
Persentase Jumlah Saham (Bulan Persentase(Bulan
Nama Jumlah Saham (Sebelumnya)
(Sebelumnya) Ini) Ini)
23,000,618,000 85% 23,000,000,000 85%
Total Pengendali
4,058,232,064 15% 4,058,850,000 15%
Total Non Pengendali
Page 3
Informasi Saham Free Float
Keterangan Bulan Sebelumnya Bulan Ini
Jumlah saham scripless dimiliki oleh pemegang saham kurang
4.058.850.000 4.058.850.000
dari 5%
Jumlah saham scripless dimiliki oleh Direksi dan Dewan
618.000 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 4.058.232.000 4.058.850.000
Jumlah saham tercatat di Bursa per akhir bulan 27.058.850.000 27.058.850.000
% Saham Free Float 15 15
Jumlah Pemegang Saham
Bulan Sebelumnya Bulan Sekarang Perubahan
7.060 6.985 75
Penerima Manfaat Akhir dari Kepemilikan Saham
Page 4
Nomor Nama
1 Yacobus Jemmy Hartanto
2 Siane Soetanto
Demikian untuk diketahui.
Hormat Kami,
PT Jayamas Medica Industri Tbk
Daniel Kurniawan
Head of Corporate Secretary and Investor Relation
PT Jayamas Medica Industri Tbk
Sebelah Selatan Jalan By Pass RT 05 / RW 01 Kelurahan Sidomojo, Kecamatan
Telepon : +62 31 8982349, Fax : , www.onemed.co.id
Nama Pengirim Daniel Kurniawan
Jabatan Head of Corporate Secretary and Investor Relation
Tanggal dan Waktu 04-08-2023 11:15
Lampiran 1. OMED 31 JULI 2023.pdf
Dokumen ini merupakan dokumen resmi PT Jayamas Medica Industri Tbk yang tidak memerlukan tanda tangan
karena dihasilkan secara elektronik oleh sistem pelaporan elektronik. PT Jayamas Medica Industri Tbk bertanggung
jawab penuh atas informasi yang tertera didalam dokumen ini.
Page 5
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Letter / Announcement No. 054/DIR-JMI/VIII/23
Issuer Name PT Jayamas Medica Industri Tbk
Issuer Code OMED
Listing Board Main
Attachment 1
Subject Monthly Report of Securities Holders Registration
The Company hereby announce Monthly Report of Securities Holders Registration which ends in 31 July 2023
as follows:
Security Administration Bureau: PT. Datindo Entrycom
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
Leonard Jl. Tanjung Golf Direksi 0 0% 0 0%
Hariadi G.1-8,
Lakarsantri,
Surabaya
Louis Krisnadi Kencanasari Direksi 0 0% 0 0%
Hartanto Barat 1/A-4,
Surabaya
Eka Jl. Woodland Direksi 0 0% 0 0%
Suwignyoo WL 2 No 11,
Share Citraland,
Ownership > Surabaya
5% PT Intisumber Komplek Darmo 22,540,000,00 83.3% 22,540,000,0 83.3%
Hasilsempurn Park II Blok IV 0 00 X
no. 14-15,
Surabaya
Yacobus Kencanasari Komisaris 230,618,000 0.85% 230,000,000 0.85%
Jemmy Barat 1/A-4, X
Surabaya
Siane Kencanasari Komisaris 230,000,000 0.85% 230,000,000 0.85%
Soetanto Barat 1/A-4, X
Surabaya
BRIGJEN Jl. Rantai Timah Komisaris 0 0% 0 0%
(PURN) Dr. G-27, Jakarta
Page 6
Number of Percent of Number of Percent of
Name Address Position Shares in Shares in Shares in Shares in Controller Affiliation
Share Previous Previous Current Current
Ownership > Dra. Herlien Jl. Ketintang Direksi 0 0% 0 0%
5% Sri Ariani, Selatan XII/17,
Karah,
Jambangan,
Surabaya
0 0% 0 0%
Masyarakat - Warkat - Scrip
4.058.232.00 15% 4.058.850. 15%
Masyarakat - Non Warkat - Scripless 0 000
0 0% 0 0%
Saham Treasury
27.058.850.0 100% 27.058.850.0 100%
Total 00 00
Percentage Number of Shares (This Percentage (This
Name Number of Shares (Previously)
(Previous) Month) Month)
23,000,618,000 85% 23,000,000,000 85%
Total Controller
4,058,232,064 15% 4,058,850,000 15%
Total Non-Controllers
Page 7
Free Float Share Information
Information Previous Month This Month
The number of scripless shares owned by shareholders is less
4.058.850.000 4.058.850.000
than 5%
The number of scripless shares owned by the Board of Directors
618.000 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 4.058.232.000 4.058.850.000
The number of shares listed on the Exchange at the end of the
27.058.850.000 27.058.850.000
month
% Free Float Share 15 15
Number of Shareholders
Previous Month This Month Change
7.060 6.985 75
Final Beneficiaries of Share Ownership
Page 8
Number Name
1 Yacobus Jemmy Hartanto
2 Siane Soetanto
Thus to be informed accordingly.
Respectfully,
PT Jayamas Medica Industri Tbk
Daniel Kurniawan
Head of Corporate Secretary and Investor Relation
PT Jayamas Medica Industri Tbk
Sebelah Selatan Jalan By Pass RT 05 / RW 01 Kelurahan Sidomojo, Kecamatan
Phone : +62 31 8982349, Fax : , www.onemed.co.id
Sender Name Daniel Kurniawan
Function Head of Corporate Secretary and Investor Relation
Date and Time 04-08-2023 11:15
Attachment 1. OMED 31 JULI 2023.pdf
This is an official document of PT Jayamas Medica Industri Tbk that does not require a signature as it was
generated electronically by the electronic reporting system. PT Jayamas Medica Industri 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
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confidence 0.900
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12 Sep 2026 22:06
Raw output
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'treasury': {'pct': '0', 'shares': '0'},
'under5_non_warkat': {'pct': '15', 'shares': '4058850000'},
'under5_warkat': {'pct': '0', 'shares': '0'}},
'as_of_date': '2023-07-31',
'checksum_ok': True,
'checksum_parts': '27058850000',
'holders': [{'address': 'Jl. Tanjung Golf G.1-8, Lakarsantri,',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'Leonard Hariadi',
'page_no': 1,
'pct': '0',
'pct_prev': '0',
'position': 'Direksi',
'seq': 0,
'shares': '0',
'shares_prev': '0'},
{'address': 'Surabaya Kencanasari Barat 1/A-4,',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'Louis Krisnadi Hartanto',
'page_no': 1,
'pct': '0',
'pct_prev': '0',
'position': 'Direksi',
'seq': 1,
'shares': '0',
'shares_prev': '0'},
{'address': 'Surabaya Jl. Woodland WL 2 No 11, Citraland,',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'Eka Suwignyoo',
'page_no': 1,
'pct': '0',
'pct_prev': '0',
'position': 'Direksi',
'seq': 2,
'shares': '0',
'shares_prev': '0'},
{'address': 'Surabaya Komplek Darmo Park II Blok IV no. 14-15,',
'category': 'FIVE_PCT',
'is_controller': True,
'is_controller_affiliate': False,
'name': 'Intisumber Hasilsempurn',
'page_no': 1,
'pct': '83.3',
'pct_prev': '83.3',
'position': '',
'seq': 3,
'shares': '22540000000',
'shares_prev': '22540000000'},
{'address': 'Surabaya Kencanasari Barat 1/A-4,',
'category': 'BOARD',
'is_controller': True,
'is_controller_affiliate': False,
'name': 'Yacobus Jemmy',
'page_no': 1,
'pct': '0.85',
'pct_prev': '0.85',
'position': 'Komisaris',
'seq': 4,
'shares': '230000000',
'shares_prev': '230618000'},
{'address': 'Surabaya Kencanasari Barat 1/A-4,',
'category': 'BOARD',
'is_controller': True,
'is_controller_affiliate': False,
'name': 'Siane Soetanto',
'page_no': 1,
'pct': '0.85',
'pct_prev': '0.85',
'position': 'Komisaris',
'seq': 5,
'shares': '230000000',
'shares_prev': '230000000'},
{'address': 'Jl. Rantai Timah G-27, Jakarta',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'BRIGJEN (PURN) Dr.',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Komisaris',
'seq': 6,
'shares': '0',
'shares_prev': '0'},
{'address': 'Jl. Ketintang Selatan XII/17,',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'Dra. Herlien Sri Ariani,',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Direksi',
'seq': 7,
'shares': '0',
'shares_prev': '0'}],
'issuer_name': 'PT Jayamas Medica Industri Tbk',
'issuer_ticker': 'OMED',
'layout': 'EREP_COVER',
'letter_number': '054/DIR-JMI/VIII/23',
'listing_board': 'Utama',
'period_label': 'Juli 2023',
'registrar': 'PT. Datindo Entrycom',
'total_shares': '27058850000'}