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20260309_ASDM_Laporan Bulanan Registrasi Pemegang Efek//Perubahan Struktur Pemegang Saham_32051869.pdf
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Extracted text 12
Page 1
Go To English Page Nomor Surat B.019/Dir-Keu/III/2026 Nama Perusahaan Asuransi Dayin Mitra Tbk Kode Emiten ASDM Papan Pencatatan Pengembangan Lampiran 3 Perihal Laporan Bulanan Registrasi Pemegang Efek Bersama ini Asuransi Dayin Mitra 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 Asuransi Dayin Mitra Tbk bertanggung jawab penuh atas informasi yang tertera didalam dokumen ini. Perseroan menyampaikan Laporan Bulanan Registrasi Pemegang Efek yang berakhir pada 28 Februari 2026 Sebagai Berikut : Biro Administrasi Efek: PT. Datindo Entrycom
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
DEWI Wisma Hayam Direksi 0 0% 0 0%
MANDRAWAN Wuruk Lt. 7, Jl.
Hayam Wuruk
No. 8, Jakarta
10120
PURNAMA Wisma Hayam Direksi 0 0% 0 0%
HADIWIDJAJ Wuruk Lt. 7, Jl.
Hayam Wuruk
No. 8, Jakarta
10120
VICTOR Wisma Hayam Direksi 0 0% 0 0%
MARIA S Wuruk Lt. 7, Jl.
Hayam Wuruk
Pemegang No. 8, Jakarta
Saham 10120
ROSA Wisma Hayam Direksi 0 0% 0 0%
Direksi dan
DJUNAIDI Wuruk Lt. 7, Jl.
Komisaris
Hayam Wuruk
No. 8, Jakarta
10120
BUSTOMI Wisma Hayam Komisaris 0 0% 0 0%
USMAN Wuruk Lt. 7, Jl.
Hayam Wuruk X
No. 8, Jakarta
10120
RATNAWATI Wisma Hayam Komisaris 0 0% 0 0%
ATMODJO Wuruk Lt. 7, Jl.
Hayam Wuruk
No. 8, Jakarta
10120
BISMA Wisma Hayam Komisaris 0 0% 0 0%
SUBRATA Wuruk Lt. 7, Jl.
Hayam Wuruk
No. 8, Jakarta
10120
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 EQUITY WISMA HAYAM 281.593.800 73,3% 281.593.800 73,3%
DEVELOPOM WURUK LT.3,
JL. HAYAM X
WURUK NO. 8,
Pemegang JAKARTA
saham 5% PT PRIMA WISMA HAYAM 20.371.200 5,3% 20.371.200 5,3%
(lima persen) TUNAS WURUK LT.9,
atau lebih JL. HAYAM
WURUK,
JAKARTA
PSAT
PT KOMPLEK 23.076.000 6% 23.076.000 6%
ARTHAVEST RUKO ATAP
MERAH BLOK
B1
JL.PECENONG
Pemegang Saham < 5%
6.436.680 1,7% 6.436.680 1,7%
Publik - Warkat
52.522.320 13,7% 52.522.320 13,7%
Publik - Non Warkat
0 0% 0 0%
Saham Treasuri
384.000.000 100% 384.000.000 100%
Total
Page 4
Informasi Saham Free Float
Keterangan Bulan Sebelumnya Bulan Ini
Jumlah saham non-warkat dimiliki oleh seluruh pemegang
52.522.320 52.522.320
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 52.522.320 52.522.320
Jumlah saham tercatat di Bursa per akhir bulan 384.000.000 384.000.000
% Saham Free Float 13,68 13,68
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
1.053 1.051 2
Pemilik Manfaat dari Asuransi Dayin Mitra Tbk
Pemegang Saham
Nomor Nama Langsung
Perseroan
1 Pinnacle Asia Diversified Fund (dimana Jamil Bin Mohamed sebagai Penerima Manfaat tidak Tidak
langsung)
Pemilik Manfaat dari Pemegang Saham lebih dari 10%
Demikian untuk diketahui.
Hormat Kami,
Asuransi Dayin Mitra Tbk
Efran Sinaga
Manager
Page 6
Asuransi Dayin Mitra Tbk
Wisma Hayam Wuruk Lt. 7 Jl. Hayam Wuruk No. 8 Jakarta 10120
Telepon : 021-80868888, Fax : 021-3453457, www.asuransidayinmitra.com
Nama Pengirim Efran Sinaga
Jabatan Manager
Tanggal dan Waktu 09-03-2026 21:30
Lampiran 1. ASDM-3.pdf
2. ASDM-1.pdf
3. ASDM-2.pdf
Dokumen ini merupakan dokumen resmi Asuransi Dayin Mitra Tbk yang tidak memerlukan tanda tangan karena
dihasilkan secara elektronik oleh sistem pelaporan elektronik. Asuransi Dayin Mitra Tbk bertanggung jawab penuh
atas informasi yang tertera didalam dokumen ini.
Page 7
Go To Indonesian Page Letter / Announcement No. B.019/Dir-Keu/III/2026 Issuer Name Asuransi Dayin Mitra Tbk Issuer Code ASDM Listing Board Development Attachment 3 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 Asuransi Dayin Mitra 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 28 February 2026 as follows: Security Administration Bureau: PT. Datindo Entrycom
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
DEWI Wisma Hayam Direksi 0 0% 0 0%
MANDRAWAN Wuruk Lt. 7, Jl.
Hayam Wuruk
No. 8, Jakarta
10120
PURNAMA Wisma Hayam Direksi 0 0% 0 0%
HADIWIDJAJ Wuruk Lt. 7, Jl.
Hayam Wuruk
No. 8, Jakarta
10120
VICTOR Wisma Hayam Direksi 0 0% 0 0%
MARIA S Wuruk Lt. 7, Jl.
Hayam Wuruk
Board of
No. 8, Jakarta
Directors and
10120
Board of ROSA Wisma Hayam Direksi 0 0% 0 0%
Commission DJUNAIDI Wuruk Lt. 7, Jl.
ers Hayam Wuruk
No. 8, Jakarta
10120
BUSTOMI Wisma Hayam Komisaris 0 0% 0 0%
USMAN Wuruk Lt. 7, Jl.
Hayam Wuruk X
No. 8, Jakarta
10120
RATNAWATI Wisma Hayam Komisaris 0 0% 0 0%
ATMODJO Wuruk Lt. 7, Jl.
Hayam Wuruk
No. 8, Jakarta
10120
BISMA Wisma Hayam Komisaris 0 0% 0 0%
SUBRATA Wuruk Lt. 7, Jl.
Hayam Wuruk
No. 8, Jakarta
10120
Number of Percent of Number of Percent of Affiliate of
Affiliate of the
Shareholders Name Address Shares in Shares in Shares in Shares in Controller the
Beneficial Owner
of 5% (five Previous Previous Current Current Controller
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 EQUITY WISMA 281,593,800 73.3% 281,593,800 73.3%
DEVELOPOM HAYAM
WURUK LT.3,
X
JL. HAYAM
WURUK NO.
Shareholders 8, JAKARTA
of 5% (five PT PRIMA WISMA 20,371,200 5.3% 20,371,200 5.3%
TUNAS HAYAM
percent) or
more WURUK LT.9,
JL. HAYAM
WURUK,
JAKARTA
PSAT
PT KOMPLEK 23,076,000 6% 23,076,000 6%
ARTHAVEST RUKO ATAP
MERAH BLOK
B1
JL.PECENON
GAN
6.436.680 1,7% 6.436.680 1,7%
Public - Scrip
52.522.320 13,7% 52.522.320 13,7%
Public - Scripless
0 0% 0 0%
Treasury Stock
384.000.000 100% 384.000.000 100%
Total
Page 10
Free Float Share Information
Information Previous Month This Month
The number of scripless shares owned by shareholders is less
52.522.320 52.522.320
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 52.522.320 52.522.320
The number of shares listed on the Exchange at the end of the
384.000.000 384.000.000
month
% Free Float Share 13,68 13,68
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
1.053 1.051 2
Beneficial Owner from Asuransi Dayin Mitra Tbk
Company’s Direct
Number Name
Shareholders
1 Pinnacle Asia Diversified Fund (dimana Jamil Bin Mohamed sebagai Penerima Tidak
Manfaat tidak langsung)
Beneficial Owner of Shareholders more than 10%
Thus to be informed accordingly.
Respectfully,
Asuransi Dayin Mitra Tbk
Efran Sinaga
Manager
Page 12
Asuransi Dayin Mitra Tbk
Wisma Hayam Wuruk Lt. 7 Jl. Hayam Wuruk No. 8 Jakarta 10120
Phone : 021-80868888, Fax : 021-3453457, www.asuransidayinmitra.com
Sender Name Efran Sinaga
Function Manager
Date and Time 09-03-2026 21:30
Attachment 1. ASDM-3.pdf
2. ASDM-1.pdf
3. ASDM-2.pdf
This is an official document of Asuransi Dayin Mitra Tbk that does not require a signature as it was generated
electronically by the electronic reporting system. Asuransi Dayin Mitra Tbk is fully responsible for the information
contained within this document.
Names mentioned 15 people and organisations named in the text · linked when the evidence is strong
unresolved
org
PT. Datindo Entrycom
· Biro Administrasi Efek
p.1 ×2
unresolved
person
BUSTOMI Wisma Hayam
· Komisaris
p.2 ×2
unresolved
person
RATNAWATI Wisma Hayam
· Komisaris
p.2 ×2
unresolved
person
Hayam
· Komisaris
p.2 ×2
unresolved
—
Sebelumnya Sebelumny
p.3
unresolved
org
PT EQUITY WISMA HAYAM
p.3
unresolved
org
PT PRIMA WISMA HAYAM
p.3
unresolved
org
Pinnacle Asia Diversified Fund (dimana Jamil Bin Mohamed sebagai Penerima Manfaat
p.5
unresolved
person
Efran Sinaga
· Manager
p.5 ×2
unresolved
—
DEWI
· Direksi
p.8
unresolved
—
VICTOR
· Direksi
p.8
unresolved
—
BISMA
· Komisaris
p.8
unresolved
org
PT PRIMA
p.9
unresolved
—
TUNAS
p.9
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
275 ms
12 Sep 2026 22:30
Raw output
{'aggregates': {'total': {'pct': '100', 'shares': '384000000'},
'treasury': {'pct': '0', 'shares': '0'},
'under5_non_warkat': {'pct': '13.7', 'shares': '52522320'},
'under5_warkat': {'pct': '1.7', 'shares': '6436680'}},
'as_of_date': '2026-02-28',
'checksum_ok': True,
'checksum_parts': '384000000',
'holders': [{'address': 'Wisma Hayam Wuruk Lt. 7, Jl. Hayam Wuruk',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'DEWI MANDRAWAN',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Direksi',
'seq': 0,
'shares': '0',
'shares_prev': '0'},
{'address': 'No. 8, Jakarta 10120 Wisma Hayam Wuruk Lt. 7, Jl. '
'Hayam Wuruk',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'PURNAMA HADIWIDJAJ',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Direksi',
'seq': 1,
'shares': '0',
'shares_prev': '0'},
{'address': 'No. 8, Jakarta 10120 Wisma Hayam Wuruk Lt. 7, Jl. '
'Hayam Wuruk',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'VICTOR MARIA S',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Direksi',
'seq': 2,
'shares': '0',
'shares_prev': '0'},
{'address': 'No. 8, Jakarta 10120 Wisma Hayam Wuruk Lt. 7, Jl. '
'Hayam Wuruk',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'ROSA DJUNAIDI',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Direksi',
'seq': 3,
'shares': '0',
'shares_prev': '0'},
{'address': 'No. 8, Jakarta 10120 Wisma Hayam Wuruk Lt. 7, Jl. '
'Hayam Wuruk',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': True,
'name': 'BUSTOMI USMAN',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Komisaris',
'seq': 4,
'shares': '0',
'shares_prev': '0'},
{'address': 'No. 8, Jakarta 10120 Wisma Hayam Wuruk Lt. 7, Jl. '
'Hayam Wuruk',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'RATNAWATI ATMODJO',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Komisaris',
'seq': 5,
'shares': '0',
'shares_prev': '0'},
{'address': 'No. 8, Jakarta 10120 Wisma Hayam Wuruk Lt. 7, Jl.',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'BISMA SUBRATA',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Komisaris',
'seq': 6,
'shares': '0',
'shares_prev': '0'},
{'address': 'WISMA HAYAM WURUK LT.3, JL. HAYAM',
'category': 'FIVE_PCT',
'is_controller': True,
'is_controller_affiliate': False,
'name': 'PT EQUITY DEVELOPOM',
'page_no': 3,
'pct': '73.3',
'pct_prev': '73.3',
'position': '',
'seq': 7,
'shares': '281593800',
'shares_prev': '281593800'},
{'address': 'WURUK NO. JAKARTA WISMA HAYAM WURUK LT.9, JL. HAYAM',
'category': 'FIVE_PCT',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'PT PRIMA TUNAS',
'page_no': 3,
'pct': '5.3',
'pct_prev': '5.3',
'position': '',
'seq': 8,
'shares': '20371200',
'shares_prev': '8.20'},
{'address': 'WURUK, JAKARTA PSAT KOMPLEK RUKO ATAP MERAH BLOK B1 '
'JL.PECENONG',
'category': 'FIVE_PCT',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'PT ARTHAVEST',
'page_no': 3,
'pct': '6',
'pct_prev': '6',
'position': '',
'seq': 9,
'shares': '23076000',
'shares_prev': '23076000'}],
'issuer_name': 'Asuransi Dayin Mitra Tbk',
'issuer_ticker': 'ASDM',
'layout': 'EREP_COVER',
'letter_number': 'B.019/Dir-Keu/III/2026',
'listing_board': 'Pengembangan',
'period_label': 'Februari 2026',
'registrar': 'PT. Datindo Entrycom',
'total_shares': '384000000'}