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Page 1 OCR 0.916
(5)sinarmas MSIGIife
Amemberor PENKISIAGI INSURANCE GROUP

No : 22/AISMSIG-CSEC/VII/2023

Kepada:

Kepala Eksekutif Pengawas Pasar Modal
Otoritas Jasa Keuangan

Jakarta

Dengan hormat,

Dalam rangka memenuhi ketentuan dalam Peraturan
Otoritas Jasa Keuangan No. 42/ POJK.04/2020 tentang
Transaksi Afiliasi dan Transaksi Benturan Kepentingan
(“POJK 42/2020”), dengan ini
informasi atas transaksi afiliasi, sebagai berikut:

kami melaporkan

Uraian transaksi afiliasi

Pada 17 Juli 2023, PT Asuransi Jiwa Sinarmas MSIG Tbk
(“Perusahaan”) membuat program tidak memaksa
untuk memberikan penghargaan kepada karyawan
dalam bentuk manfaat tunai. Manfaat tunai diberikan
dengan syarat bahwa manfaat tunai tersebut akan
disimpan dalam bentuk saham Perusahaan selama

18 Juli 2023

Dear Sir/Ma'am,

In order to comply with provisions under the Financial

Services Authority Regulation No. 42/POJK.04/2020

concerning Related Party Transactions and Conflict of

Interest Transactions ("POJK 42/2020"), we herewith

report the information regarding to related

transactions, as follows.
Details of related party transaction

On 17 July 2023, PT Asuransi Jiwa Sinarm 5 Tbk

(“the Company”) initiated a discretionary program for
rewarding its employees with cash benefit. Cash benefit

Is granted with conditions that it needs to be held in the

form of restricted share of the Company for 2 years (24

months) period and shall be released only if the employee

jangka waktu 2 tahun (24 bulan) dan akan dilepaskan
hanya jika karyawan tersebut tetap bekerja di
Perusahaan hingga periode tersebut berakhir.

In with the Company until ends of

'ock-up period.

Uraian program yang dimaksud adalah sebagai berikut: The detail of the program is as follows

Aspek/Aspei Uraian/Detail

Periode Program 1tahun/ye'
Prog Wuli/July 2023 — Juni/June 2024)
Periode lock-up
Lock
Jumlah karyawan yang akan
mendapatkan penghargaan

am Period

2 tahun/ years

o Period
Up

82 orang/employees

rployee

Program akan dilaksanakan sesuai dengan salah satu dari 3 skenario di bawah ini:

It will be executed following one of 3 scenarios below
Kisaran harga per
Skenario lembar saham Biaya Maksimal
Estimasi jumlah biaya Scenario The range price per Maximum cost
program share
Estir cost Fi Rp50 - Rp5.999 « Rp5.999x 100 saham/shares x 68

orang/persons x 12” - Rp 489.518.400, -
(maksimal/maximum)

# Rp5.999 x 200 saham/shares x 14
orang/persons x 12” - Rp 201.566.400, -
(maksimal/maximum)

program

PT Asuransi Jiwa Sinarmas MSIG Tbk.
Kantor Manajemen & Layanan Nasabah
Sinarmas MSIG Tower, Lt. 6, Jin. Jend. Sudirman Kav. 21, Jakarta 12920, Indonesia, Telepon: (021) 5059 7777 (Hunting), Fax. (021) 5060 8899
Kantor Pusat
Wisma Eka Jiwa, Lt. 8-9, Jln. Mangga Dua Raya, Jakarta Pusat 10730, Telepon: (021) 6257808, 50309999
PT Asuransi Jiwa Sinarmas MSIG Tbk. telah terdaftar dan berada di bawah pengawasan OJK |

Page 2 OCR 0.911
(5)sinarmas MSIGIife

A Member of INSURANCE GROUP

2 Rp6.000 — Rp3.999 .

Rp9.999 x 100 saham/shares x 68
orang/persons x 6" - Rp 407.959.200, -
(maksimal/maximum)

#  Rp9.999x 200 saham/sharesx 14
orang/persons x 6” - Rp 167.983.200, -
(maksimal/maximum)

3 ? Rp3.999

e  Rp15.000x 100 saham/shares x 68
orang/persons x 4" - Rp 408.000.000, -

€#  Rp15.000x 200 saham/sharesx14
orang/persons x4" - Rp 168.000.000, -

“) 12/6/4 adalah kemungkinan frekuensi maksimal, frekuensi pengalokasian saham akan berkurang jika harga

saham naik (mengikuti skenario yang disediakan)

“)12/6/4 is possible maximum freguency, freguency of allocation of stock will be reduced if the share price goes

higher (following provided scenario)

Hubungan antara para pihak

Sesuai dengan POJK 42/2020, pegawai Perusahaan
merupakan salah satu pihak yang memenuhi kriteria
sebagai afiliasi Perusahaan.

Penjelasaan, pertimbangan dan alasan
dilakukannya transaksi afiliasi, dibandingkan
dengan apabila dilakukan transaksi lain yang

sejenis yang tidak dilakukan dengan pihak afiliasi

Pertimbangan dan alasan Perusahaan melakukan
transaksi afiliasi tersebut adalah:

1. Untuk mempertahankan supaya karyawan
tertentu tetap bersama Perusahaan, dengan
memberikan bonus tambahan, dengan syarat
bahwa bonus akan disimpan dalam bentuk
saham Perusahaan selama masa lock-up
tertentu,

2. Untuk menyelaraskan kepentingan karyawan
dan pemegang saham, yang akan meningkatkan
kinerja Perusahaan secara keseluruhan.

Pernyataan Dewan Komisaris dan Direksi

Direksi dan Dewan Komisaris dengan ini menyatakan
bahwa sepanjang pengetahuan dan keyakinan Direksi

dan Dewan Komisaris Perusahaan, bahwa:

# Transaksi tersebut bukan merupakan transaksi
benturan kepentingan sebagaimana dimaksud
dalam POJK 42/2020 mengingat tidak terdapat
perbedaan antara kepentingan ekonomis
Perusahaan dengan kepentingan ekonomis

Relationship between the parties

Based on POJK 42/2020, the Company's employees
are one of the parties that meet the criteria for
affiliation of the Company.

Explanation, consideration and reason for
conducting the related party transaction, compared
to it that conducted with a non-related party

The Company's consideration and reason for carrying
out the related party transactions are.

1. To retain certain employees within AISM, by
providing extra bonus, but with condition that
the bonus will be held in form of LIFE shares
with lock-up period.

2. To align the interest of employees and
shareholders, and thus will improve overall
Company's performance.

Statement of the Board of Commissioners and Board
of Directors

The Board of Directors and the Board of
Commissioners hereby state that to the best of the
knowledge and belief of the Board of Directors and
the Board of Commissioners of the Company, that:

# The transaction is not @ conflict-of-interest
transaction as referred to in POJK 42/2020
considering that there is no difference between
the economic interests of the Company and the

personal economic interests of the Board of
Page 3 OCR 0.909
(#)sinarmas MSIGIife
A Member of INSURANCE GROUP

pribadi Direksi, Dewan Komisaris. dan
Pemegang Saham Utama atau Pengendali
Perusahaan yang dapat merugikan Perusahaan

karena Transaksi.

material terkait transaksi
afiliasi telah diungkapkan dalam laporan kepada
OJK dan tidak menyesatkan.

# Semua informasi

Informasi tambahan

Kami juga melampirkan informasi pendukung berupa
salah satu Surat Pemberitahuan kepada karyawan,
sebagai referensi tambahan.

Demikian laporan ini kami sampaikan.

perhatiannya, kami ucapkan terima kasih.

Atas

Hormat kami,

€ PT Asuransi Jiwa Sinarmas MSIG Tbk

Wakil Presiden Direktur

Direktur

Directors, Board of Commissioners and Major
or Controlling Shareholders of the Company
which may harm the Company because of the
Transaction.

e All material information with respect to the
related party transaction have been disclosed in
the report to OJK and are not misleading.

Additional information

We also attach supporting information, i.e. one of the
Notification Letter to employee, for your reference.

Thus we convey accordingly. Thank you for your
attention.

pa ml

Tomoyuki Monden
Page 4 OCR 0.919
sinarmas MSIG life

A Member of INSURANCE GROUP
Jakarta, 17 July 2023

Personal & Confidential

Dear Mr. Aditya Indrawanto,

lam delighted to confirm you have been awarded a discretionary program 2023 SMiLe Long Term
Incentive Program (LTIP) as appreciation and to reward performance employees toward their overall
contribution and success of PT Asuransi Jiwa Sinarmas MSIG Tbk. (“Company”).

This LTIP provided as cash benefit to the overall compensation and benefits package, subject to fully
non-disclosure to any third party without the prior consent of the Company and will temporarily be
placed in the form of restricted of the Company shares to be vested or released if you remain your
employment of the Company in 2 (two) years ahead and not under a notice of termination or
resignation.

Enclose with this letter is your LTIP certificate setting out information of the program and guideline to
provide further details regarding the operation mechanism of your LTIP.

Should you have any gueries regarding your LTIP, please contact Human Capital - Rewards & Service
Delivery.

I would like to take this opportunity to thank you for your continued contribution to our Company.

Yours sincerely,

f2 8
GEA
Satoshi Shiratani

Vice President Director

PT Asuransi Jiwa Sinarmas MSIG Tbk.
Kantor Manajemen & Layanan Nasabah

Sinarmas MSIG Tower, Lt. 6, Jin. Jend. Sudirman Kav. 21, Jakarta 12920, Indonesia, Telepon: (021) SOS9 7777 (Hunting), Fax. (021) 5060 8899
Kantor Pusat

Wisma Eka Jlwa, Lt. 8-8, Jin. Mangga Dua Raya. Jakarta Pusat 10730, Telepon: (021) 62578086, 50309994

01x |

(PT Asuransi Jiwa Sinarmas MSIG Tbk. telah terdaftar dan berada dibawah pengawasan

File

File Open PDF
Source IDX
Size0.81 MB
Published18 Jul 2023
Pages4
Characters8,712
Text sourceOCR
OCR confidence0.913

Names mentioned 0 people and organisations named in the text · linked when the evidence is strong

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Extraction attempts how the parser did, and what it refused

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Rule parser Needs review confidence 0.091 306 ms 13 Sep 2026 17:40
Raw output
{'appraiser_exempt': None,
 'appraiser_name': '',
 'assets': [],
 'currency': None,
 'fact_type': '',
 'issuer_name': '',
 'kind': 'CONFLICT',
 'kjpp_name': '',
 'letter_number': '',
 'object_text': '',
 'object_truncated': False,
 'parties': [],
 'pct_of_equity': None,
 'reference_period': '',
 'requires_rups': None,
 'rups_date': None,
 'ticker': '',
 'transaction_date': None,
 'valuation_date': None,
 'value': None}

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