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20260625_ASDM_Laporan Informasi dan Fakta Material_32104644_lamp1.pdf

Board change Needs review ASDM

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Page 1 OCR 0.910
Jakarta, 25 Juni 2026
No. Ref.: B.061/CS/VI/2026

Kepada Yth. / 70

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 Informasi atau

Fakta Material
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

Attn. Chief Executive functioning as

Capital Markets, Financial
Derivatives, and Carbon Exchange
Supervisor

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:

: PT Asuransi Dayin Mitra Tbk (ASDM)

Bidang Usaha / Scope of Business : Asuransi Umum Konvensional / General Insurance

Telepon / Teleohone
Alamat surat elektronik / e-mail

:021-80868888
: csecretaryAdayinmitra.com

1. | Tanggal 24 Juni 2026 1. | Date of Event | June 24, 2026
Kejadian
2. | Jenis Keterbukaan Informasi 2 | Type of Information
Informasi atau | terkait ' pengunduran Material disclosure on
Fakta Material | diri anggota Dewan Information resignation of &
Komisaris Perseroan or Fact member of the
yaitu Presiden Company's Board of

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 0.902
Komisaris Perseroan.

Commissioners ie.
the Company
President
Commissioner.

3. | Uraian
Informasi atau
Fakta Material

Pada tanggal 24 Juni
2026 Perseroan telah
menerima surat
permohonan

pengunduran diri dari
Bapak Bustomi Usman

selaku Presiden
Komisaris Perseroan,
efektif terhitung sejak:
a. Pengunduran diri
Bapak Bustomi
Usman dan
pengangkatan
Bapak Hendra
Godjali — sebagai

Presiden Komisaris
Perseroan disetujui
oleh Rapat Umum
Pemegang Saham
Tahunan

Perseroan — yang
akan
diselenggarakan

pada tanggal 26
Juni 2026, dan

b. Bapak Hendra
Godjali
memperoleh
kelulusan uji
kemampuan dan
kepatutan (Fit

and Proper) dari
Otoritas Jasa
Keuangan.

Description of|
Material
Information

or Fact

On June 24, 2026,
the Company
received a
resignation letter
from Mr. Bustomi
Usman as the
Companys President
Commissioner,

effective upon the
Fulfilment of the
following conditions:

a. the resignation of
Mr. Bustomi Usman
and the appointment
Of Mr. Hendra Godjali
as President
Commissioner of the
Company having
been approved at the
Company's — Annual
General Meeting of
Shareholders to be
held on 26 June
2026, and

b. Mr. Hendra Godjali
having obtained a
passing result in the
fit and proper test
conducted by the
Financial Services
Authority — (Otoritas
Jasa Keuangan
OJK),

PT ASURANSI

General

Insurance

DAYIN MITRA Tbk
Page 3 OCR 0.859
In compliance with

Selanjutnya untuk provisions of POJIK
memenuhi ketentuan Number:
POJK Nomor: 33/POJK.04/2014
33/POJK.04/2014 concerning Board of'
tentang Direksi dan Directors and Board
Dewan Komisaris of Commissioners of
Emiten atau Issuer or Public
Perusahaan Publik, Company, the
maka Perseroan akan Company will hold
menyelenggarakan General Meeting of
Rapat Umum Shareholders to
Pemegang Saham adopt a resolution on
untuk — memutuskan the  reguest for
permohonan resignation — of a
pengunduran diri member of the
anggota Dewan Company's Board of
Komisaris Perseroan. Commissioner.

Dampak Tidak ada 4 | Impact of the| None

kejadian, event or

informasi atau material

fakta material information or

tersebut fact on the

terhadap Operations,

kegiatan legal matters,

operasional, financial

hukum, condition — or

kondisi business

keuangan, continuity of

atau the Issuer or

kelangsungan Public

usaha Emiten Company

atau
Perusahaan
Publik

PT ASURANSI

General

Insurance

DAYIN MITRA Tbk

Page 4 OCR 0.918
5. | Keterangan Tidak ada 5. | Other None
lain-lain information

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

4 Hormat kami, / Best Regards,
| PT Asuransi Dayin Mitra Tbk

Nag

Purnama Hadiwidjaja
Corporate Secretary

PT ASURANSI DAYIN MITRA Tbk

General Insurance

File

File Open PDF
Source IDX
Size0.19 MB
Published25 Jun 2026
Pages4
Characters4,329
Text sourceOCR
OCR confidence0.898

Names mentioned 7 people and organisations named in the text · linked when the evidence is strong

linked org Asuransi Dayin Mitra Tbk p.1 ×17
linked person Purnama Hadiwidjaja p.4
possible org Otoritas Jasa Keuangan p.1 ×3
possible person Bustomi Usman p.2 ×7
possible person Hendra Godjali p.2 ×7
unresolved org Financial Services Authority p.2
unresolved org ASURANSI General Insurance DAYIN MITRA Tbk p.2 ×4

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