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20251127_ASDM_Laporan Informasi dan Fakta Material_31988189_lamp1.pdf

Board change Needs review ASDM

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Page 1 OCR 0.910
Jakarta, 27 November 2025
No. Ref.: B.114/CS/XI/2025

Kepada Yth. / To

Otoritas Jasa Keuangan (OJK)
Gedung Sumitro Djojohadikusumo
Jl. Lapangan Banteng Timur No. 2-4
Jakarta 10710

Up. Kepala Eksekutif Pengawas Pasar Modal,
Keuangan Derivatif, dan Bursa Karbon

Perihal : Keterbukaan
Material

Informasi atau Fakta

Dengan hormat,

Dengan ini kami untuk dan atas nama PT Asuransi
Dayin Mitra Tbk (“Perseroan”), menyampaikan
Keterbukaan Informasi atau Fakta Material sebagai
berikut:

Nama Emiten / Name of Issuer
Bidang Usaha / Scope of Business

Telepon / Telephone
Alamat surat elektronik / e-mail

Attn. Chief Executive of Capital Markets, Financial

Derivatives, and Carbon — Exchange
si Ai
Re. : Disclosure of Material Information or Fact
Dear Sir/Madam,

For and on behalf of PT Asuransi Dayin Mitra Tbk
("the Company"), we hereby convey the following
Disclosure of Material Information or Fact as
follows:

: PT Asuransi Dayin Mitra Tbk (ASDM)

: Asuransi Umum Konvensional / General Insurance
1 021-80863888

: csecretary@dayinmitra.com

27 November 2025
November 27, 2025

1. | Tanggal Kejadian
Date of Event

2. | Jenis Informasi
atau Fakta

Material

Type of Material
Information or Fact

Perubahan Susunan anggota Dewan Komisaris Perseroan.
Amendment to the Composition of the Company's Board of Commissioners.

3. | Uraian Informasi
atau Fakta Material
Description Of
Material

Information or Fact

Berdasarkan hasil keputusan Rapat Umum Pemegang Saham Luar Biasa
(Rapat), yang dilaksanakan pada hari Kamis, 27 November 2025, Rapat
dengan suara terbanyak memutuskan:

Based on the results of the decisions of the Extraordinary General Meeting
Of Shareholders (the Meeting), which was held on Thursday, November 27,
2025, the Meeting with the majority of votes decided:

PT ASURANSI DAYIN MITRA Tbk

WISMA HAYAM WURUK, 7" floor » Jl. Hayam Wuruk No. 8 » Jakarta 10120 - Indonesia
T. (62-21) 8086 8888 (Hunting) » Website : www.asuransidayinmitra.com

General

Insurance

Anggota AAUI No. 073.01041999.2.01

Page 2 OCR 0.935
1. Menyetujui pengunduran diri Ibu Imelda Siahaja selaku . Komisaris

Independen Perseroan, dengan ucapan terima kasih atas sumbangan
tenaga dan pikiran selama menjabat sebagai Komisaris Independen
Perseroan.
Approving the resignation of Ms. Imelda Siahaja as Independent
Commissioner of the Company, with thanks for his contribution of energy
and thoughts while serving as Independent Commissioner of the
Company.

2. Menyetujui pengangkatan Bapak Bisma Subrata sebagai Komisaris
Independen Perseroan.
Approving the appointment of Mr. Bisma Subrata as Independent
Commissioner of the Company.

Pengangkatan Bapak Bisma Subrata sebagai Komisaris Independen
tersebut efektif berlaku sejak ditutupnya Rapat, dengan masa jabatan
menyesuaikan sisa masa jabatan anggota Direksi dan Dewan Komisaris
Perseroan lainnya yang sedang menjabat.

The appointment of Mr. Bisma Subrata as Independent Commissioner
Shall become effective as of the closing of the meeting, with the term of
Office adjusted to the remaining term of office of the other members of
the Company's Board of Directors and Board of Commissioners who are
currentiy serving.

Sehingga terhitung sejak ditutupnya Rapat hari ini sampai dengan
penutupan Rapat Umum Pemegang Saham Tahunan Perseroan yang akan
diselenggarakan pada tahun 2027, dengan tidak mengurangi Hak Rapat
Umum Pemegang Saham untuk memberhentikan anggota Direksi dan
Dewan Komisaris sewaktu-waktu, susunan Direksi dan Dewan Komisaris
Perseroan selengkapnya adalah sebagai berikut:

So starting from the dosing of today's Meeting until the closing of the
Company's Annual General Meeting of Shareholders which will be held in
2027, without prejudice to the Rights of the General Meeting of
Shareholders to dismiss members of the Board of Directors and Board of
Commissioners at any time, the complete composition of the Company
Directors and Board of Commissioners is as follows:

Direksi/ Board of Directors :

Presiden Direktur/ President Director : Ibu Dewi Mandrawan
Direktur/ Director : Bapak Purnama Hadiwidjaja
Direktur/ Director : Bapak Victor Maria S Sandjaja
Direktur/ Director : Ibu Rosa Djunaidi

PT ASURANSI DAYIN MITRA Tbk

General Insurance
Page 3 OCR 0.935
Dewan Komisaris/ Board of Commissioners :

Presiden Komisaris/ : Bapak Bustomi Usman
President Commissioner

Komisaris Independen/ : Ibu Ratnawati Atmodjo
Independent Commissioner

Komisaris Independen : Bapak Bisma Subrata
Independent Commissioner

3. Memberikan kuasa kepada Direksi Perseroan dengan hak substitusi, untuk

menyatakan kembali keputusan Rapat yang telah diambil dalam mata
acara Rapat ini dalam suatu akta Notaris dan selanjutnya memberitahukan
dan/atau mendaftarkan keputusan tersebut kepada Menteri Hukum dan
Hak Asasi Manusia Republik Indonesia dan/atau instansi lain yang
berwenang serta melakukan segala tindakan yang diperlukan dengan
tidak ada satu tindakanpun yang dikecualikan, sesuai dengan dan
sebagaimana disyaratkan oleh ketentuan perundang-undangan.
Grant authority to the Company's Directors with the right of substitution,
to restate the Meeting decisions that have been taken in the agenda of.
this second Meeting in a Notarial deed and then notify and/or register the
decision to the Minister of Law and Human Rights of the Republic of
Indonesia and/or other agencies authorized person and carry out all
necessary actions without exception, in accordance with and as reguired
by statutory provisions.

Dampak kejadian,
informasi atau
fakta material
tersebut terhadap
kegiatan
operasional,
hukum, kondisi
keuangan, — atau
kelangsungan
usaha Emiten atau
Perusahaan Publik
Impact of the
event or material
information or fact
on the operations,
legal matters,
financial condition
or business
continuity of the

Tidak ada
None

PT ASURANSI DAYIN MITRA Tbk

General Insurance

Page 4 OCR 0.899
Issuer or Public

Company

5. | Keterangan lain- | Tidak ada
lain None
Other information

&

Demikian pemberitahuan ini kami sampaikan, atas 7hus we convey this information. Thank you for
perhatiannya kami ucapkan terima kasih. your kind attention.

A.Hormat kami, / Best Regards,
Y PT Asuransi Dayin Mitra Tbk

Na

Purnama Hadiwidjaja
Corporate Secretary

PT ASURANSI DAYIN MITRA Tbk

General Insurance

File

File Open PDF
Source IDX
Size0.42 MB
Published27 Nov 2025
Pages4
Characters6,214
Text sourceOCR
OCR confidence0.920

Names mentioned 14 people and organisations named in the text · linked when the evidence is strong

linked org Asuransi Dayin Mitra Tbk p.1 ×23
linked person Imelda Siahaja p.2 ×3
linked person Dewi Mandrawan · President Director p.2 ×2
linked person Purnama Hadiwidjaja · Director p.2 ×2
linked person Victor Maria S Sandjaja · Director p.2
linked person Ibu Rosa Djunaidi · Director p.2
possible org Otoritas Jasa Keuangan p.1
possible person Bustomi Usman p.3
unresolved — Pengangkatan Bapak Bisma Subrata · Komisaris Independen p.2 ×11
unresolved org Rosa Djunaidi PT ASURANSI DAYIN MITRA Tbk p.2
unresolved person Ratnawati Atmodjo Independent p.3 ×2
unresolved person Bisma Subrata Independent p.3
unresolved org Menteri p.3
unresolved org Minister of Law and Human Rights p.3

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