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20240921_SILO_Laporan Kepemilikan atau Setiap Perubahan Kepemilikan Saham Perusahaan Terbuka_31727829_lamp1.pdf
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Extracted text 6
Page 1
No. 086/Corsec-SIH/IX/2024 Tangerang, 21 September 2024
Kepada Yth. / To.
Otoritas Jasa Keuangan
Gedung Soemitro Djojohadikusumo
Jl. Lapangan Banteng Timur 1-4
Jakarta 10701
Up. Yth. Bapak Inarno Djajadi
Kepala Eksekutif Pengawas Pasar Modal
Executive Chief of the Capital Market Supervisory
Perihal : Laporan Kepemilikan atau Setiap Subject: Report on Shares Ownership or Changes
Perubahan Kepemilikan Saham in Shares Ownership of a Public
Perusahaan Terbuka Company
Dengan hormat, Dear Sir,
Sesuai dengan Peraturan Otoritas Jasa Keuangan Pursuant to Article 4 of the Financial Services
Nomor 4/POJK.04/2024 tentang Laporan Authority Regulation Number 11/POJK/04/2017
Kepemilikan atau Setiap Perubahan Kepemilikan regarding Reporting Share Ownership or Changes in
Saham Perusahaan Terbuka dan Laporan Aktivitas Share Ownership in Public Companies and Report on
Menjaminkan Saham Perusahaan Terbuka, Activities Involving the Pledging of Shares of a
bersama ini PT Siloam International Hospitals Tbk Publicly Listed Company, herewith PT Siloam
(“Perseroan”) melaporkan Keterbukaan Informasi International Hospitals Tbk (the “Company”)
Pemegang Saham Tertentu, dengan rincian reporting the Disclosure Information of Certain
sebagai berikut: Shareholders, with the following details:
Kategori / Classification of Shareholder Termasuk >5% / >5%
Status Pengendali / Controlling Shareholder Tidak / No
Nama Perusahaan Terbuka / Name of Public PT Siloam International Hospitals Tbk (SILO)
Company
Alamat / Address Gedung Fak. Kedokteran UPH Lt. 32, Jl. Boulevard
Jend. Sudirman No. 15, Lippo Village, Tangerang -
Banten 15810, Indonesia
Kewarganegaraan / Citizenship Asing / Foreigner
Nama Pemegang Saham / Name of Shareholder Prime Health Company Limited
Jenis Transaksi / Type of Transaction Penjualan / Selling
Page 2
Jumlah saham dan persentase kepemilikan Sebelum transaksi / Before transaction
sebelum dan setelah transaksi / Number of
shares and its percentage of ownership before Saham / Shares %
and after transaction 3.405.587.432 26,18
Setelah transaksi / After transaction
Saham / Shares %
1.045.607.832 8,04
Jumlah saham yang dibeli atau dijual / Number 2.359.979.600 saham / shares
of shares bought or sold
Harga pembelian atau penjualan per saham / Rp 2.850,- per saham / shares
Price per shares
Tanggal transaksi / Transaction date 13 September 2024
Tujuan dari transaksi / Transaction purpose Divestasi saham / Divestment of shares
Status kepemilikan saham / Share ownership Langsung / Direct
status
Demikian kami sampaikan, terima kasih atas Thus we convey, thank you for your attention and
perhatian dan kerjasamanya. cooperation.
Hormat kami/Sincerely yours,
PT Siloam International Hospitals Tbk
Ratih Permata Putri Hadiwinoto
Corporate Secretary
Tembusan: Cc:
Direksi PT Bursa Efek Indonesia Board of Director of Indonesia Stock Exchange
Page 3
PRIME HEALTH COMPANY LIMITED
C/O Mourant Ozannes Corporate Service, 94 Solaris Avenue, Camana Bay PO BOX 1384 KYI-1108,
Cayman Islands
20 September 2024
Regarding / Perihal : Report on the Shareholding of or Any Change to the Shareholding of a Public
Company / Laporan Kepemilikan atau Setiap Perubahan Kepemilikan Saham
Perusahaan Terbuka
To / Kepada Yth.:
Chief Executive of Capital Markets, Financial Derivatives and Carbon Exchange Supervisor of Financial
Services Authority / Kepala Eksekutif Pengawas Pasar Modal, Keuangan Derivatif, dan Bursa Karbon
Otoritas Jasa Keuangan
Gedung Soemitro Djojohadikusumo
Jl. Lapangan Banteng Timur 2-4
Jakarta Pusat 10710
Dear Sir, Dengan hormat,
We, the undersigned: Kami yang bertanda tangan di bawah ini:
Name / Nama : Prime Health Company Limited
Complete Address / Alamat Lengkap : C/O Mourant Ozannes Corporate Service, 94 Solaris
Avenue, Camana Bay PO BOX 1384 KYI-1108, Cayman
Islands
Telephone Number / Nomor Telepon : -
Nationality / Kewarganegaraan : A company incorporated in Cayman Islands / Suatu
perusahaan yang didirikan di Kepulauan Cayman.
Email address / Alamat email : -
in accordance with Article 2 (2) of Regulation of the sesuai dengan Pasal 2 (2) Peraturan Otoritas Jasa
Financial Services Authority No. 4 of 2024 Keuangan No. 4 tahun 2024 tentang Laporan
concerning Report on the Shareholding of or Any Kepemilikan atau Setiap Perubahan Kepemilikan
Change to the Shareholding of a Public Company Saham Perusahaan Terbuka dan Laporan Aktivitas
and Report on the Activity of Encumbering Shares of Menjaminkan Saham Perusahaan Terbuka, melapor
a Public Company, hereby report that we own shares bahwa kami memiliki saham Perusahaan Terbuka
in the Public Company as detailed below: dengan rincian sebagai berikut:
1. Name of shares of Public Company / Nama PT Siloam International Hospitals Tbk (“SILO”)
saham Perusahaan Terbuka
2. Amount of shares and shareholding percentage Before / Sebelum After / Setelah
with voting rights before and after transaction / Amount of Shares / Amount of Shares /
Jumlah saham dan persentase kepemilikan Jumlah Saham: Jumlah Saham:
saham dengan hak suara sebelum dan 3,405,587,432 / 1,045,607,832 /
sesudah transaksi1 3.405.587.432 1.045.607.832
Percentage of Voting Percentage of Voting
Rights / Persentase Hak Rights / Persentase Hak
Suara: 26.23% / 26,23% Suara: 8.05% / 8,05%
1
Calculation of the percentage of voting rights does not take into account treasury shares. At 31 August 2024, the treasury shares
of SILO amount to 23,880,200 shares. For information completeness, if the calculation of shareholding percentage takes into
account treasury shares, the shareholding percentage before transaction is 26.18% and the shareholding percentage after
transaction is 8.04%. / Perhitungan persentase hak suara tidak memperhitungkan saham treasuri. Pada tanggal 31 Agustus
2024, jumlah saham treasuri SILO adalah 23.880.200 saham. Untuk kelengkapan informasi, apabila perhitungan persentase
kepemilikan saham memperhitungkan saham treasuri, persentase kepemilikan saham sebelum transaksi adalah 26,18% dan
persentase kepemilikan saham setelah transaksi adalah 8,04%.
1
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PRIME HEALTH COMPANY LIMITED
C/O Mourant Ozannes Corporate Service, 94 Solaris Avenue, Camana Bay PO BOX 1384 KYI-1108,
Cayman Islands
3. Type of transaction conducted / Jenis transaksi 1. Purchase / Pembelian;
yang dilakukan 2. Sale / Penjualan;
3. Exercise of Equity Securities / Pelaksanaan
(exercise) Efek bersifat Ekuitas;
4. Grant / Hibah;
5. Inheritance / Waris;
6. Execution of encumbranced shares of public
company / Eksekusi atas saham Perusahaan
Terbuka yang dijaminkan;
7. Others / Lainnya: -
Is the purchase or sale transaction a repurchase
agreement transaction? / Apakah transaksi
pembelian atau penjualan merupakan transaksi
repurchase agreement?
☐ Yes / Ya
☒ No / Tidak
Amount of unexercised Deadline of
Equity Securities / implementation period /
Jumlah Efek bersifat Batas akhir periode
Ekuitas yang belum pelaksanaan: -
dilaksanakan: -
4. Amount of shares purchased, sold, or 2,359,979,600 shares / 2.359.979.600 saham.
transferred / Jumlah saham yang dibeli, dijual,
atau dialihkan
5. Share Classification / Klasifikasi saham ☒ ordinary shares / saham biasa
☐ shares with multiple voting rights / saham dengan
hak suara multipel
6. Purchase or sale price per share / Harga IDR2,850 per share / Rp2.850 per saham.
pembelian atau penjualan per saham
7. Transaction date / Tanggal transaksi 13 September 2024.
8. Purpose of transaction / Tujuan transaksi Divestment of shares / Divestasi saham
9. Status of shareholding (direct or indirect) / ☒ Direct / Langsung
Status kepemilikan saham (langsung atau tidak ☐ Indirect, through... / Tidak Langsung, melalui ...
langsung)
10. Remarks of controller / Keterangan pengendali ☐ Yes / Ya
If Yes, will it maintain control? / Jika Ya, apakah
akan mempertahankan pengendalian?
☐ Yes / Ya
☐ No / Tidak
☒ No / Tidak
11. Name of shareholder granting authority to -
report, if the shareholding report is delegated /
Nama pemegang saham yang memberikan
2
Page 5
PRIME HEALTH COMPANY LIMITED
C/O Mourant Ozannes Corporate Service, 94 Solaris Avenue, Camana Bay PO BOX 1384 KYI-1108,
Cayman Islands
kuasa untuk melaporkan, jika laporan
kepemilikan saham dikuasakan
12. Information on details of members of organized -
group, if it is a shareholding report by an
organized group / Informasi mengenai rincian
anggota kelompok yang terorganisasi, jika
merupakan laporan kepemilikan saham oleh
kelompok yang terorganisasi
Please be advised accordingly and thank you for Demikian disampaikan, atas perhatiannya kami
your kind attention. ucapkan terima kasih.
[signature page to follow / halaman tanda tangan pada halaman selanjutnya]
3
Page 6
PRIME HEALTH COMPANY LIMITED
C/O Mourant Ozannes Corporate Service, 94 Solaris Avenue, Camana Bay PO BOX 1384 KYI-1108,
Cayman Islands
Yours sincerely, / Hormat kami,
Prime Health Company Limited
_________________________________
Name / Nama : Andy Nugroho Purwohardono
Title / Jabatan : Director / Direktur
Copied to / Tembusan:
1. PT Bursa Efek Indonesia; and / dan
2. PT Siloam International Hospitals Tbk.
4
Names mentioned 12 people and organisations named in the text · linked when the evidence is strong
unresolved
person
Inarno Djajadi Kepala Eksekutif Pengawas
p.1
unresolved
org
PT Siloam
p.1
unresolved
org
International Hospitals Tbk
p.1
unresolved
org
Prime Health Company Limited
p.1 ×7
unresolved
person
Ratih Permata Putri Hadiwinoto
· Corporate Secretary
p.2
unresolved
org
Indonesia Stock Exchange
p.2
unresolved
org
Financial Services Authority
p.3 ×2
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confidence 0.235
2521 ms
12 Sep 2026 22:58
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