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Page 1 OCR 0.933
No. 255/LGI-Dir/X/2024
Lampiran/Annex: 81 halaman/pages

Kepada Yth.

1. Otoritas Jasa Keuangan
Gedung Wisma Mulia 2 Lantai 12
Jl.Jenderal Gatot Subroto Kav.42,
Jakarta Selatan 10270
U.p Yth: Ibu Dewi Astuti
Kepala Departemen Pengawasan
Asuransi dan Jasa Penunjang

2. Otoritas Jasa Keuangan
Gedung Sumitro Djojohadikusumo
Jl.Lapangan Banteng Timur No.2-4
Jakarta Pusat 10710
u.p Yth: Ibu Novira Indrianingrum
Kepala Departemen Pengawasan Emiten
dan Perusahaan Publik

Perihal: Laporan Penunjukan Akuntan
Publik dan/atau Kantor Akuntan
Publik dalam rangka audit atas
informasi keuangan historis
tahunan pada 31 Desember 2024
PT Lippo General Insurance Tbk
(“Perseroan”)

Dengan hormat,

Berdasarkan Peraturan Otoritas Jasa
Keuangan No. 9 Tahun 2023 tentang
Penggunaan Jasa Akuntan Publik dan
Kantor Akuntan Publik dalam Kegiatan Jasa
Keuangan dan Surat Edaran Otoritas Jasa
Keuangan No.18/SEOJK.03/2023 tentang
Tata Cara Penggunaan Jasa Akuntan Publik
dan Kantor Akuntan Publik dalam Kegiatan
Jasa Keuangan, dengan ini melaporkan
bahwa berdasarkan Keputusan Rapat
Umum Pemegang Saham pada tanggal 29
April 2024, RUPS Tahunan telah menyetujui
memberikan kewenangan kepada Dewan

LGI

acompanyof Hanwha

Jakarta, 17 Oktober 2024/October 17, 2024

To:

1. Financial Services Authority
Wisma Mulia 2 Building, 12th Floor
Jl. Jenderal Gatot Subroto Kav. 42,
South Jakarta 10270
Attn: Mrs. Dewi Astuti
Head of Department Insurance
Supervision and Supporting Services

2. Financial Services Authority
Sumitro Djojohadikusumo Building JI.
Lapangan Banteng Timur No. 2-4
Central Jakarta 10710
Attn: Mrs. Novira Indrianingrum
Head of Department Issuer and Public
Company Supervision

Subject: Report on the Appointment of a
Public Accountant and/or
Public Accounting Firm for the
Audit of Historical Financial
Information for the Year Ended
December 31, 2024 PT Lippo
General Insurance Tbk (the
“Company”)

Yours faithfully,

In accordance with the Financial Services
Authority Regulation No. 9 of 2028 on the
Use of Public Accountant Services and
Public Accounting Firms in Financial
Services Activities and the Financial
Services Authority Circular Letter No.
18/SEOJK.03/2023 on Procedures for the
Use of Public Accountant Services and
Public Accounting Firms in Financial
Services Activities, we hereby report that,
based on the decision of the Annual General
Meeting of Shareholders (AGMS) held on
April 29, 2024, the AGMS has approved to

Wp

PT Lippo General Insurance Tbk | www.igi.co.id
HO: Lippo Kuningan Building 27"fl. unit A & F, Jl. H.R. Rasuna Said Kav. B-12 - Jakarta Selatan 12940 Indonesia | T: 462 21 525 6161
Operational HO: Karawaci Office Park block I unit 30-35, Lippo Village - Tangerang 15139 Indonesia | T: #62 21 5579 0683
Page 2 OCR 0.924
Komisaris Perseroan untuk melakukan
penunjukan Akuntan Publik (AP) dan Kantor
Akuntan Publik (KAP) serta berdasarkan
Surat Keputusan Dewan Komisaris No.SK-
006/BOC-CS/X/2024 tanggal 8 Oktober
2024 telah dilakukan penunjukan Akuntan
Publik (AP) dan Kantor Akuntan Publik
(KAP) dalam rangka audit atas informasi
keuangan historis tahunan pada 31
Desember 2024 untuk tahun buku 2024
sebagai berikut:

1. Akuntan Publik
a. Nama
Riki Afrianof, CPA

b. Nomor registrasi AP dari Menteri
Keuangan
AP.1017

c. Nomor Surat Tanda Terdaftar
STTD. AP-116/NB.122/2018

d. Tahun Penugasan

2024
2. Kantor Akuntan Publik
a. Nama
Kantor Akuntan Publik — Suharli

Sugiharto dan Rekan

b. Nomor Surat Tanda Terdaftar
STTD.KAP-25/PM.223/2020

Sesuai dengan Lampiran Il Formulir 1

SEOJK No.18 Tahun 2023, sebagai

kelengkapan dokumen pelaporan dengan ini

kami sampaikan sebagai berikut:

1. Form 01.01 — Laporan Penunjukan AP
dan KAP untuk Audit atas Informasi
Keuangan Historis Tahunan — Lembaga

LGI

acompanyof Hanwha

grant authority to the Company's Board of
Commissioners to appoint a Public
Accountant (AP) and Public Accounting Firm
(KAP).
Subseguently, based on the Board of
Commissioners' Decree No. SK-006/BOC-
CS/X/2024 dated October 8, 2024, the
appointment of the Public Accountant (AP)
and Public Accounting Firm (KAP) for the
audit of annual historical financial
information as of December 31, 2024, forthe
Tinancial year 2024, has been carried out as
follows:
1. Public Accountant
a. Name
Riki Afrianof, CPA

b. Public Accountant registration
number from the Minister of Finance
AP.1017

c. Registered License Number
STTD. AP-116/NB.122/2018

d. Year of Appointment
2024

2. Public Accounting Firm
a. Name

Suharli Sugiharto dan Rekan Public
Accounting Firm

b. Registered License Number
STTD.KAP-25/PM.223/2020

In accordance with Annex Il, Form 1 of

SEOJK No. 18 of 2023, as part of the

reporting document completeness, we

hereby submit the following:

1. Form 01.01 — Report on the Appointment
of Public Accountant (AP) and Public
Accounting Firm (KAP) for the Audit of
Annual Historical Financial Information —
Institution.

Uap

PT Lippo General Insurance Tbk | www.lgi.co.id

HO: Lippo Kuningan Building 27" fl. unit A & F, Jl. H.R. Rasuna Said Kav. B-12 - Jakarta Selatan 12940 Indonesia | T: 6221 525 6161
Operational HO: Karawaci Office Park block I unit 30-35, Lippo Village - Tangerang 15139 Indonesia | T: 6221 5579 0683
Page 3 OCR 0.914
2. Form 01.02 — Dokumen Penunjukan AP
dan KAP untuk Audit atas Informasi
Keuangan Historis Tahunan, antara lain:
a. Akta Risalah — Rapat Umum

Pemegang Saham Tahunan
Perseroan — yang — menyatakan
kewenangan kepada Dewan
Komisaris untuk melakukan
penunjukan AP dan KAP,
. Perjanjian kerja antara Perseroan
dan KAP:
. Hasil penilaian sendiri (self-
assessment) pemenuhan
pembatasan penggunaan jasa audit
dan masa jeda yang diterima dari
KAP: dan

. Rekomendasi Komite Audit dan

pertimbangan yang digunakan dalam
memberikan rekomendasi
penunjukan AP dan KAP.

LGI

acompanyof Hanwha

2.Form 01.02 — Documents for the

Appointment of AP and KAP for the Audit
of Annual Historical Financial Information,
including:

a. Deed of the Minutes of the Annual
General Meeting of Shareholders of the
Company stating the authority granted
to the Board of Commissioners to
appoint the Public Accountant (AP) and
Public Accounting Firm.

b. Engagement agreement between the
Gompany and Public Accounting Firm.

c. Results of the self-assessment
regarding the compliance with the
restrictions on the use of audit services
and the cooling off period received from
the KAP, and

d. Audit Committee's recommendation
and considerations used in making the
recommendation for the appointment

of AP and KAP.

Demikian penunjukan ini kami sampaikan, This is the report on the appointment that we
atas perhatian dan kerjasamanya terima submitted. We thank you for your attention
kasih. and cooperation.

Hormat kami,
Sincerely,
PT Lippo General Insurance Tbk

Kwon Gi Han
Direktur/Director Presiden Direktur/President Director

Tembusan/CC:

- Direktorat Lembaga dan Profesi Penunjang Pasar Modal/ Directorate of Institutions and
Supporting Professions in the Capital Market

- Direktorat Jasa Penunjang IKNB/Directorate of Supporting Services for Non-Bank Financial
Institutions (IKNB)

PT Lippo General Insurance Tbk | www:Igi.co.id
HO: Lippo Kuningan Building 27"fl. unit A & F, Jl. H.R. Rasuna Said Kav. B-12 - Jakarta Selatan 12940 Indonesia | T: -62 21 525 6161
Operational HO: Karawaci Office Park block | unit 30-35, Lippo Village - Tangerang 15139 Indonesia | T: 62 21 5579 0683

File

File Open PDF
Source IDX
Size0.55 MB
Published22 Oct 2024
Pages3
Characters7,342
Text sourceOCR
OCR confidence0.924

Names mentioned 16 people and organisations named in the text · linked when the evidence is strong

linked org Lippo General Insurance Tbk p.1 ×17
possible org Otoritas Jasa Keuangan p.1 ×4
possible person Gatot Subroto p.1 ×2
possible person Kwon Gi Han · Direktur/Director Presiden Direktur/President Director p.3
unresolved org Dewi Astuti Kepala Departemen Pengawasan Asuransi p.1
unresolved org Departemen Pengawasan Asuransi dan Jasa p.1
unresolved org Novira Indrianingrum Kepala Departemen Pengawasan p.1
unresolved org Departemen Pengawasan Emiten dan Perusahaan Publik p.1
unresolved org Financial Services Authority p.1 ×4
unresolved person Dewi Astuti Head p.1
unresolved person Novira Indrianingrum Head p.1
unresolved person Nama Riki Afrianof p.2 ×2
unresolved org Menteri Keuangan AP. p.2
unresolved org Suharli Sugiharto dan Rekan p.2 ×2
unresolved org Minister of Finance AP. p.2
unresolved org Bank Financial Institutions p.3

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