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20260625_ASDM_Laporan Informasi dan Fakta Material_32104644_lamp2.pdf

Board change Needs review ASDM

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Page 1 OCR 0.891
Jakarta, 25 Juni 2026
No. Ref.: B.062/CS/VI/2026

Kepada Yth. / 70

PT Bursa Efek Indonesia
Gedung Bursa Efek Indonesia
Tower I lantai 6

Jl. Jend. Sudirman Kav. 52-53
Jakarta 12190

Up. Direksi Attn. Board of Directors

Perihal: Keterbukaan Informasi atau Re. : Disclosure of Material Information
Fakta Material or Fact

Dengan hormat, Dear Sir/Madam,

Dengan ini kami untuk dan atas nama PT Forand on behalf of PT Asuransi Dayin Mitra
Asuransi Dayin Mitra Tbk (“Perseroan”) 7bk ("the Company") we hereby convey the

menyampaikan Keterbukaan Informasi atau following Disclosure of Material Information

Fakta Material sebagai berikut: or Fact:

Nama Emiten / Name of Issuer — : PT Asuransi Dayin Mitra Tbk (ASDM)

Bidang Usaha / Scope of Business : Asuransi Umum Konvensional / General Insurance
Telepon / Telephone : 021-80868888

Alamat surat elektronik / e-mmai/ — : csecretary@dayinmitra.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
Komisaris Perseroan. Commissioners Le.
the Company

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 0.900
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
rom 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
Companys — Annual
General Meeting of
Shareholders to be
held on 26 June
2026, and

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

PT ASURANSI DAYIN MITRA Tbk

General

Insurance

Page 3 OCR 0.868
Selanjutnya untuk In compliance with
memenuhi ketentuan provisions of POJIK
POJK Nomor: Number:
33/POJK.04/2014 33/POJK.04/2014
tentang Direksi dan concerning Board of
Dewan Komisaris Directors and Board
Emiten atau of Commissioners of
Perusahaan — Publik, Issuer or Public
maka Perseroan akan Company, the
menyelenggarakan Company will hold
Rapat Umum General Meeting of
Pemegang Saham Shareholders to
untuk memutuskan adopt a resolution on
permohonan the reguest — for
pengunduran diri resignation of @
anggota Dewan member Of the
Komisaris Perseroan. Company's Board of!
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

Keterangan Tidak ada 5. | Other None

lain-lain information

PT ASURANSI DAYIN MITRA Tbk

General

Insurance
Page 4 OCR 0.896
Demikian pemberitahuan ini kami sampaikan, 7hus we convey this information. Thank you
atas perhatiannya kami ucapkan terima for your kind attention.
kasih.

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

nan

Purnama Hadiwidjaja
Corporate Secretary

PT ASURANSI DAYIN MITRA Tbk

General Insurance

File

File Open PDF
Source IDX
Size0.18 MB
Published25 Jun 2026
Pages4
Characters4,178
Text sourceOCR
OCR confidence0.889

Names mentioned 9 people and organisations named in the text · linked when the evidence is strong

linked org Asuransi Dayin Mitra Tbk p.1 ×19
linked person Purnama Hadiwidjaja p.4
possible org PT Bursa Efek Indonesia p.1 ×2
possible person Bustomi Usman p.2 ×7
possible person Hendra Godjali · Presiden Komisaris p.2 ×7
possible org Otoritas Jasa Keuangan p.2 ×2
unresolved org PT Forand p.1
unresolved org Financial Services Authority p.2

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