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20260306_LABS_Laporan Bulanan Registrasi Pemegang Efek//Perubahan Struktur Pemegang Saham_32041501.pdf
Shareholder register Parsed LABSSource file signed link, expires in 15 minutes
Extracted text 12
Page 1
Go To English Page Nomor Surat 01.011/CS-MM/LABS/III/26 Nama Perusahaan PT UBC Medical Indonesia Tbk Kode Emiten LABS Papan Pencatatan Pengembangan Lampiran 1 Perihal Laporan Bulanan Registrasi Pemegang Efek Bersama ini PT UBC Medical Indonesia Tbk menyatakan: 1. Bertanggung jawab atas penyusunan dan penyajian Laporan Bulanan Registrasi Pemegang Efek (LBRE). 2. Semua informasi dalam LBRE telah dimuat secara lengkap dan benar, tidak mengandung informasi atau fakta material yang tidak benar, dan tidak menghilangkan informasi atau fakta material. 3. Perhitungan Free Float telah disajikan sesuai dengan Peraturan Bursa Nomor I-A tentang Pencatatan Saham dan Efek Bersifat Ekuitas Selain Saham yang Diterbitkan oleh Perusahaan Tercatat, termasuk telah mengeluarkan kepemilikan saham oleh pihak Pengendali dan Afiliasi dari Pengendali, dan Afiliasi dari Pemilik Manfaat; dimiliki oleh anggota Dewan Komisaris atau anggota Direksi; dan saham yang telah dibeli kembali oleh perusahaan. Direksi atas nama PT UBC Medical Indonesia Tbk bertanggung jawab penuh atas informasi yang tertera didalam dokumen ini. Perseroan menyampaikan Laporan Bulanan Registrasi Pemegang Efek yang berakhir pada 27 Februari 2026 Sebagai Berikut : Biro Administrasi Efek: PT. Bima Registra
Page 2
Persen
Jumlah Persen
Jumlah Saham Saham Afiliasi Afiliasi Pemilik
Nama Alamat Jabatan Saham Bulan Saham Bulan Pengendali
Sebelumnya Sebelumny Pengendali Manfaat
Ini Ini
a
Suyanto Primere Estate Komisaris 0 0% 0 0%
Blok F.II
RT003/RW005 X
Setu Cipayung
Jakarta Timur
FX Yoshua Kawasan Direksi 0 0% 0 0%
Raintjung Industri
Pulogadung, Jl.
Rawa Gelam V,
Blok L, No Kav
X
11-13, Kel.
Jatinegara, Kec.
Pemegang Cakung, Jakarta
Saham Timur, Jakarta,
13930
Direksi dan
Marcella Kawasan Direksi 0 0% 0 0%
Komisaris
Angelin Industri
Pulogadung, Jl.
Rawa Gelam V,
Blok L, No Kav
X
11-13, Kel.
Jatinegara, Kec.
Cakung, Jakarta
Timur, Jakarta,
13930
Nathan Tirtana Kond. Taman Komisaris 0 0% 0 0%
Anggrek TWR
8-43 H
RT008/RW007
X
Tanjung Duren
Selatan, Grogol
Petamburan,
Jakarta Barat
Persen
Jumlah Persen
Jumlah Saham Saham Afiliasi Afiliasi Pemilik
Nama Alamat Saham Bulan Saham Bulan Pengendali
Pemegang Sebelumnya Sebelumny Pengendali Manfaat
Ini Ini
saham 5% a
(lima persen)
atau lebih
Page 3
Persen
Jumlah Persen
Jumlah Saham Saham Afiliasi Afiliasi Pemilik
Nama Alamat Saham Bulan Saham Bulan Pengendali
Sebelumnya Sebelumny Pengendali Manfaat
Ini Ini
a
PT Optel Ruko De 2.859.428.400 72,39% 2.859.428.40 72,39%
Investama Mansion Blok E 0
Pemegang no.7 Alam
saham 5% X
Sutera, 15143
(lima persen) Kota Tangerang
atau lebih Banten
PT Inodia Perkantoran 0 0% 0 0%
Kedoya Elok
Plaza Blok Db
X
24, Jl. Panjang
11520 Jakarta
Jakarta
Pemegang Saham < 5%
260.000.000 6,58% 260.000.00 6,58%
Publik - Warkat 0
830.571.600 21,03% 830.571.60 21,03%
Publik - Non Warkat 0
0 0% 0 0%
Saham Treasuri
3.950.000.00 100% 3.950.000.00 100%
Total 0 0
Page 4
Informasi Saham Free Float
Keterangan Bulan Sebelumnya Bulan Ini
Jumlah saham non-warkat dimiliki oleh seluruh pemegang
830.571.600 830.571.600
saham kurang dari 5%
Jumlah saham non-warkat dimiliki oleh Direksi dan Dewan
0 0
Komisaris kurang dari 5%
Jumlah saham non-warkat dimiliki oleh Pengendali kurang dari 5% 0 0
Jumlah saham non-warkat dimiliki oleh Afiliasi dari Pengendali 0 0
kurang dari 5%
Jumlah saham tresuri non-warkat kurang dari 5% 0 0
Jumlah saham portfolio investasi dengan penerima manfaat
0 0
investor publik yang telah disetujui Bursa untuk diperhitungkan
sebagai Free Float
Jumlah saham Free Float 830.571.600 830.571.600
Jumlah saham tercatat di Bursa per akhir bulan 3.950.000.000 3.950.000.000
% Saham Free Float 21,03 21,03
Persentase Bulan
Keterangan Bulan Sebelumnya Bulan Ini Persentase Bulan Ini
Sebelumnya
Jumlah saham tidak tercatat 0 0% 0 0%
Page 5
Jumlah Pemegang Saham Nasabah Pemilik SID
Bulan Sebelumnya Bulan Sekarang Perubahan
2.088 1.982 106
Pemilik Manfaat dari PT UBC Medical Indonesia Tbk
Pemegang Saham
Nomor Nama Langsung
Perseroan
1 Nathan Tirtana Tidak
Pemilik Manfaat dari Pemegang Saham lebih dari 10%
Nama Pemilik
Jumlah Saham Persen Saham
Nomor Nama Pemegang Saham Manfaat dari
Bulan Ini Bulan Ini
Pemegang Saham
1 PT Optel Investama Mulia 2.859.428.400 72,39 Nathan Tirtana
Demikian untuk diketahui.
Hormat Kami,
PT UBC Medical Indonesia Tbk
Franciscus Xaverius Yoshua Raintjung
Direktur Utama
Page 6
PT UBC Medical Indonesia Tbk
Kawasan Industri Pulogadung, Jl. Rawa Gelam V, Blok L, No Kav 11-13, Kel.
Telepon : 021-38865110, Fax : , www.ubcindonesia.com
Nama Pengirim Franciscus Xaverius Yoshua Raintjung
Jabatan Direktur Utama
Tanggal dan Waktu 10-03-2026 06:47
Lampiran 1. LABS_Penyampaian Laporan Bulanan Februari 2026.pdf
Dokumen ini merupakan dokumen resmi PT UBC Medical Indonesia Tbk yang tidak memerlukan tanda tangan
karena dihasilkan secara elektronik oleh sistem pelaporan elektronik. PT UBC Medical Indonesia Tbk bertanggung
jawab penuh atas informasi yang tertera didalam dokumen ini.
Page 7
Go To Indonesian Page Letter / Announcement No. 01.011/CS-MM/LABS/III/26 Issuer Name PT UBC Medical Indonesia Tbk Issuer Code LABS Listing Board Development Attachment 1 Subject Monthly Report of Securities Holders Registration Hereby, the Company declares that: 1. It is responsible for the preparation and presentation of the Monthly Securities Holder Registration Report. 2. All information contained in the LBRE has been fully and accurately disclosed, does not contain any incorrect material information or facts, and does not omit any material information or facts. 3. The Free Float calculation has been presented in accordance with Exchange Regulation Number I-A concerning the Listing of Shares and Equity Securities Other Than Shares Issued by Listed Companies, including the exclusion of share ownership by the Controlling Shareholder and its Affiliates; affiliates of beneficial owner; members of the Board of Commissioners or the Board of Directors; and treasury shares repurchased by the Company. The Board of Directors of PT UBC Medical Indonesia Tbk, on behalf of the Company, bears full responsibility for the information contained in this document. The Company hereby announce Monthly Report of Securities Holders Registration which ends in 27 February 2026 as follows: Security Administration Bureau: PT. Bima Registra
Page 8
Number of Percent of Number of Percent of Affiliate of
Affiliate of the
Name Address Position Shares in Shares in Shares in Shares in Controller the
Beneficial Owner
Previous Previous Current Current Controller
Suyanto Primere Estate Komisaris 0 0% 0 0%
Blok F.II
RT003/RW005 X
Setu Cipayung
Jakarta Timur
FX Yoshua Kawasan Direksi 0 0% 0 0%
Raintjung Industri
Pulogadung, Jl.
Rawa Gelam V,
Blok L, No Kav
X
11-13, Kel.
Jatinegara, Kec.
Board of
Cakung, Jakarta
Directors and Timur, Jakarta,
Board of 13930
Commission Marcella Kawasan Direksi 0 0% 0 0%
ers Angelin Industri
Pulogadung, Jl.
Rawa Gelam V,
Blok L, No Kav
X
11-13, Kel.
Jatinegara, Kec.
Cakung, Jakarta
Timur, Jakarta,
13930
Nathan Tirtana Kond. Taman Komisaris 0 0% 0 0%
Anggrek TWR
8-43 H
RT008/RW007
X
Tanjung Duren
Selatan, Grogol
Petamburan,
Jakarta Barat
Number of Percent of Number of Percent of Affiliate of
Affiliate of the
Name Address Shares in Shares in Shares in Shares in Controller the
Beneficial Owner
Shareholders Previous Previous Current Current Controller
of 5% (five
percent) or
more
Page 9
Number of Percent of Number of Percent of Affiliate of
Affiliate of the
Name Address Shares in Shares in Shares in Shares in Controller the
Beneficial Owner
Previous Previous Current Current Controller
PT Optel Ruko De 2,859,428,400 72.39% 2,859,428,40 72.39%
Investama Mansion Blok 0
E no.7 Alam
Shareholders Sutera, 15143 X
of 5% (five Kota
percent) or Tangerang
more Banten
PT Inodia Perkantoran 0 0% 0 0%
Kedoya Elok
Plaza Blok Db
24, Jl. X
Panjang
11520 Jakarta
Jakarta
260.000.000 6,58% 260.000.00 6,58%
Public - Scrip 0
830.571.600 21,03% 830.571.60 21,03%
Public - Scripless 0
0 0% 0 0%
Treasury Stock
3.950.000.00 100% 3.950.000.00 100%
Total 0 0
Page 10
Free Float Share Information
Information Previous Month This Month
The number of scripless shares owned by shareholders is less
830.571.600 830.571.600
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 830.571.600 830.571.600
The number of shares listed on the Exchange at the end of the
3.950.000.000 3.950.000.000
month
% Free Float Share 21,03 21,03
Remarks Previous Month Previous Month Percentage Current Month Current Month Percentage
Number of Unlisted Shares 0 0% 0 0%
Page 11
Number of Shareholders Holding SID Accounts
Previous Month Current Month Change
2.088 1.982 106
Beneficial Owner from PT UBC Medical Indonesia Tbk
Company’s Direct
Number Name
Shareholders
1 Nathan Tirtana Tidak
Beneficial Owner of Shareholders more than 10%
Percentage of Name of
Number of Shares
No Shareholders Name Shares in Current Shareholder’s
in Current Month
Month Beneficial Owner
1 PT Optel Investama Mulia 2.859.428.400 72,39 Nathan Tirtana
Thus to be informed accordingly.
Respectfully,
PT UBC Medical Indonesia Tbk
Franciscus Xaverius Yoshua Raintjung
Direktur Utama
Page 12
PT UBC Medical Indonesia Tbk
Kawasan Industri Pulogadung, Jl. Rawa Gelam V, Blok L, No Kav 11-13, Kel.
Phone : 021-38865110, Fax : , www.ubcindonesia.com
Sender Name Franciscus Xaverius Yoshua Raintjung
Function Direktur Utama
Date and Time 10-03-2026 06:47
Attachment 1. LABS_Penyampaian Laporan Bulanan Februari 2026.pdf
This is an official document of PT UBC Medical Indonesia Tbk that does not require a signature as it was generated
electronically by the electronic reporting system. PT UBC Medical Indonesia Tbk is fully responsible for the
information contained within this document.
Names mentioned 14 people and organisations named in the text · linked when the evidence is strong
unresolved
org
PT. Bima Registra
· Biro Administrasi Efek
p.1 ×2
unresolved
person
Primere Estate
· Komisaris
p.2 ×2
unresolved
person
Nathan Tirtana Kond.
· Komisaris
p.2 ×8
unresolved
—
Sebelumnya Sebelumny
p.3
unresolved
org
PT Optel
p.3 ×2
unresolved
org
Investama
p.3
unresolved
org
PT Optel Investama Mulia
p.5 ×2
unresolved
person
Franciscus Xaverius Yoshua Raintjung
· Direktur Utama
p.5 ×6
unresolved
—
FX Yoshua
· Direksi
p.8
unresolved
person
Function
· Direktur Utama
p.12
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
289 ms
12 Sep 2026 22:30
Raw output
{'aggregates': {'total': {'pct': '100', 'shares': '3950000000'},
'treasury': {'pct': '0', 'shares': '0'},
'under5_non_warkat': {'pct': '21.03', 'shares': '830571600'},
'under5_warkat': {'pct': '6.58', 'shares': '260000000'}},
'as_of_date': '2026-02-28',
'checksum_ok': True,
'checksum_parts': '3950000000',
'holders': [{'address': 'Primere Estate Blok F.II RT003/RW005',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'Suyanto',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Komisaris',
'seq': 0,
'shares': '0',
'shares_prev': '0'},
{'address': 'Setu Cipayung Jakarta Timur Kawasan Industri '
'Pulogadung, Jl. Rawa Gelam V, Blok L, No Kav',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'FX Yoshua Raintjung',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Direksi',
'seq': 1,
'shares': '0',
'shares_prev': '0'},
{'address': '11-13, Kel. Jatinegara, Kec. Cakung, Jakarta Timur, '
'Jakarta, 13930 Kawasan Industri Pulogadung, Jl. Rawa '
'Gelam V, Blok L, No Kav',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'Marcella Angelin',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Direksi',
'seq': 2,
'shares': '0',
'shares_prev': '0'},
{'address': '11-13, Kel. Jatinegara, Kec. Cakung, Jakarta Timur, '
'Jakarta, 13930 Kond. Taman Anggrek TWR',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': True,
'name': 'Nathan Tirtana',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Komisaris',
'seq': 3,
'shares': '0',
'shares_prev': '0'},
{'address': 'Ruko De Mansion Blok no.7 Alam',
'category': 'FIVE_PCT',
'is_controller': True,
'is_controller_affiliate': False,
'name': 'PT Optel Investama',
'page_no': 3,
'pct': '72.39',
'pct_prev': '72.39',
'position': '',
'seq': 4,
'shares': '2859428400',
'shares_prev': '2859428400'},
{'address': 'Sutera, 15143 Kota Tangerang Banten Perkantoran '
'Kedoya Elok Plaza Blok Db 24, Jl. Panjang 11520 '
'Jakarta Jakarta',
'category': 'FIVE_PCT',
'is_controller': False,
'is_controller_affiliate': True,
'name': 'PT Inodia',
'page_no': 3,
'pct': '0',
'pct_prev': '0',
'position': '',
'seq': 5,
'shares': '0',
'shares_prev': '0'}],
'issuer_name': 'PT UBC Medical Indonesia Tbk',
'issuer_ticker': 'LABS',
'layout': 'EREP_COVER',
'letter_number': '01.011/CS-MM/LABS/III/26',
'listing_board': 'Pengembangan',
'period_label': 'Februari 2026',
'registrar': 'PT. Bima Registra',
'total_shares': '3950000000'}