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20260908_LABS_Laporan Bulanan Registrasi Pemegang Efek//Perubahan Struktur Pemegang Saham_32145999.pdf
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Page 1
Go To English Page Nomor Surat 042/CS-MM/LABS/IX/26 Nama Perusahaan PT UBC Medical Indonesia Tbk Kode Emiten LABS Papan Pencatatan Pengembangan Lampiran 2 Perihal Laporan Bulanan Registrasi Pemegang Efek Bersama ini PT UBC Medical Indonesia Tbk menyatakan: 1. Bertanggung jawab atas penyusunan dan penyajian Laporan Bulanan Registrasi Pemegang Efek (LBRE). 2. Semua informasi dalam LBRE telah dimuat secara lengkap dan benar, tidak mengandung informasi atau fakta material yang tidak benar, dan tidak menghilangkan informasi atau fakta material. 3. Perhitungan Free Float telah disajikan sesuai dengan Peraturan Pencatatan Bursa Nomor I-A dan/atau I-V tentang Pencatatan Saham dan Efek Bersifat Ekuitas Selain Saham yang Diterbitkan oleh Perusahaan Tercatat, termasuk telah mengeluarkan kepemilikan saham oleh pihak Pengendali dan Afiliasi dari Pengendali, dan Afiliasi dari Pemilik Manfaat; dimiliki oleh anggota Dewan Komisaris atau anggota Direksi; dan saham yang telah dibeli kembali oleh perusahaan. Direksi atas nama PT UBC Medical Indonesia Tbk bertanggung jawab penuh atas informasi yang tertera didalam dokumen ini. Perseroan menyampaikan Laporan Bulanan Registrasi Pemegang Efek yang berakhir pada akhir bulan Agustus - 2026 Sebagai Berikut : Biro Administrasi Efek: PT. Bima Registra
Page 2
Persen
Jumlah Persen
Jumlah Saham Saham Afiliasi
Nama Alamat Jabatan Saham Bulan Saham Bulan Pengendali
Sebelumnya Sebelumny Pengendali
Ini Ini
a
FX Yoshua Kawasan Direksi 0 0% 0 0%
Raintjung Industri
Pulogadung, Jl.
Rawa Gelam V,
Blok L, No Kav
X
11-13, Kel.
Jatinegara, Kec.
Cakung, Jakarta
Timur, Jakarta,
13930
Nathan Tirtana Kawasan Komisaris 0 0% 0 0%
Industri
Pulogadung, Jl.
Rawa Gelam V,
Blok L, No Kav
X
11-13, Kel.
Pemegang Jatinegara, Kec.
Saham Cakung, Jakarta
Direksi dan Timur, Jakarta,
Komisaris 13930
Yudha Kawasan Direksi 0 0% 0 0%
Indrawirawan Industri
Pulogadung, Jl.
Rawa Gelam V,
Blok L, No Kav
11-13, Kel.
Jatinegara, Kec.
Cakung, Jakarta
Timur, Jakarta,
13930
Suyanto Kawasan Komisaris 0 0% 0 0%
Industri
Pulogadung, Jl.
Rawa Gelam V,
Blok L, No Kav
11-13, Kel.
Jatinegara, Kec.
Cakung, Jakarta
Timur, Jakarta,
13930
Page 3
Persen
Jumlah Persen
Jumlah Saham Saham Afiliasi
Nama Alamat Saham Bulan Saham Bulan Pengendali
Sebelumnya Sebelumny Pengendali
Pemegang Ini Ini
a
saham 5% PT Optel Ruko De 2.859.428.400 72,39% 2.859.428.40 72,39%
(lima persen) Investama Mansion Blok E 0
atau lebih no.7 Alam
X
Sutera, 15143
Kota Tangerang
Banten
Pemegang Saham < 5%
260.000.000 6,58% 260.000.00 6,58%
Pemegang Saham < 5% - Warkat 0
830.571.600 21,03% 812.571.60 20,57%
Pemegang Saham < 5% - Non Warkat 0
0 0% 18.000.000 0.46%
Saham Treasuri
3.950.000.00 100% 3.950.000.00 100%
Total 0 0
Page 4
Jumlah Saham Scrip dan Scripless berdasarkan Tipe dan Klasifikasi Investor
Tipe dan Klasifikasi Investor Jumlah Saham
Afiliasi dari pengendali 130.000.000
Direksi dan Dewan Komisaris 0
Karyawan (hanya saham yang dibatasi pengalihan
0
kepemilikannya)
Pengendali 2.859.428.400
Saham Tresuri 18.000.000
Jumlah Saham Scripless berdasarkan Tipe dan Klasifikasi Investor dari KSEI
Tipe dan Klasifikasi Investor Jumlah Saham
Bank 200
Government -
Private Equity 117.646.900
Trustee Bank -
Venture Capital -
Private Bank -
Exchange Traded Funds -
Investment Manager -
Investment Advisors 910.100
Brokerage Firms -
Page 5
Hedge Fund - Sovereign Wealth Fund - Capital Market Supporting Institutions and Professions - Commanditaire Vennootschap (CV) or Limited partnership 57.977.600 Firm - Invesment Fund Selling Agent - Peer to peer lending - Permanent establishment - Sole proprietorship - Corporate 250.050.700 Association/social organization - State-owned enterprises - Central Bank - State Owned Company - Diocese - Conference - Congregation - Cooperatives - International organization - Political parties -
Page 6
Partnership - Educational Institution - Mutual Funds (MF) - Securities Company (SC) - Pension Funds (PF) - Financial Institutional (IB) - Insurance (IS) - Foundation (FD) - Individual (ID) 403.986.100 *Data klasifikasi investor yang disajikan dalam laporan ini bersumber dari informasi yang disampaikan oleh Pemegang Rekening KSEI berdasarkan hasil verifikasi yang dilakukan melalui proses Know Your Customer (KYC) atas data investor yang dikelolanya. Penetapanan klasifikasi investor dilakukan oleh masing-masing Pemegang Rekening KSEI dengan mengacu pada definisi dan panduan klasifikasi investor yang telah disediakan oleh KSEI. Keakuratan maupun kesesuaian pada penentuan klasifikasi investor yang tersaji dalam laporan ini menjadi tanggung jawab masing-masing Pemegang Rekening KSEI yang melakukan proses klasifikasi tersebut.
Page 7
Informasi Saham Free Float
Keterangan Bulan Sebelumnya Bulan Ini
Jumlah saham non-warkat dimiliki oleh seluruh pemegang
830.571.600 812.571.600
saham kurang dari 5%
Jumlah saham non-warkat dimiliki oleh Direksi dan Dewan
0 0
Komisaris kurang dari 5%
Jumlah saham non-warkat dimiliki oleh Pengendali kurang dari 5% 0 0
Jumlah saham non-warkat dimiliki oleh Afiliasi dari Pengendali 0 0
kurang dari 5%
Jumlah saham tresuri non-warkat kurang dari 5% 0 18.000.000
Jumlah saham yang harus dibatasi pengalihan kepemilikannya
0 0
(lock up) baik berdasarkan Peraturan maupun bagian tindakan
korporasi Perusahaan Tercatat kurang dari 5%
Jumlah saham non-warkat dimiliki oleh Perusahaan Modal 117.646.900 117.646.900
Ventura dan Private Equity kurang dari 5%
Jumlah saham non-warkat yang berada dalam status sita atau 0 0
blokir oleh Aparat Penegak Hukum atau Otoritas yang
berwenang kurang dari 5%
Jumlah saham dengan penerima manfaat investor publik yang 0 0
telah disetujui Bursa untuk diperhitungkan sebagai Free Float
(Ketentuan V.2 Peraturan I-A dan Ketentuan V.2 Peraturan I-V)
Jumlah saham Free Float 712.924.700 676.924.700
Jumlah saham tercatat di Bursa per akhir bulan 3.950.000.000 3.950.000.000
% Saham Free Float 18,05 17,14
Page 8
Persentase Bulan
Keterangan Bulan Sebelumnya Bulan Ini Persentase Bulan Ini
Sebelumnya
Jumlah saham tidak tercatat 0 0% 0 0%
Jumlah Pemegang Saham Nasabah Pemilik SID
Bulan Sebelumnya Bulan Sekarang Perubahan
2.595 2.308 287
Pemilik manfaat (pengendali tingkat individu) yang terdiri dari satu pihak atau kelompok yang terorganisasi dari PT UBC Medical
Indonesia Tbk
Pemegang Saham
Nama Pemegang % Kepemilikan
Nomor Nama Pemilik Manfaat Alamat Langsung
Saham Langsung Saham*
Perseroan
1 Nathan Tirtana Kawasan Industri Tidak PT Optel Investama 72,39 %
Pulogadung, Jl. Mulia
* Persentase Kepemilikan, jika pemegang kolom pemegang saham langsung diisi:
- Ya : maka merupakan % kepemilikan pemilik manfaat langsung ke Perseroan
- Tidak : maka merupakan % kepemilikan pemengang saham langsung ke Perseroan
Demikian untuk diketahui.
Hormat Kami,
PT UBC Medical Indonesia Tbk
Franciscus Xaverius Yoshua Raintjung
Page 9
Direktur Utama
PT UBC Medical Indonesia Tbk
Kawasan Industri Pulogadung, Jl. Rawa Gelam V, Blok L, No Kav 11-13, Kel.
Telepon : 021-38865110, Fax : , www.ubcindonesia.com
Nama Pengirim Franciscus Xaverius Yoshua Raintjung
Jabatan Direktur Utama
Tanggal dan Waktu 09-09-2026 10:58
Lampiran 1. 2026.09.08_UBC_SP MONTHLY REPORT_COMPLETE.pdf
2. 1_BEI E-Reporting LABS Per Agustus 2026.pdf
Dokumen ini merupakan dokumen resmi PT UBC Medical Indonesia Tbk yang tidak memerlukan tanda tangan
karena dihasilkan secara elektronik oleh sistem pelaporan elektronik. PT UBC Medical Indonesia Tbk bertanggung
jawab penuh atas informasi yang tertera didalam dokumen ini.
Page 10
Go To Indonesian Page Letter / Announcement No. 042/CS-MM/LABS/IX/26 Issuer Name PT UBC Medical Indonesia Tbk Issuer Code LABS Listing Board Development Attachment 2 Subject Monthly Report of Securities Holders Registration Hereby, the Company declares that: 1. It is responsible for the preparation and presentation of the Monthly Securities Holder Registration Report. 2. All information contained in the LBRE has been fully and accurately disclosed, does not contain any incorrect material information or facts, and does not omit any material information or facts. 3. The Free Float calculation has been presented in accordance with Listing Exchange Regulation Number I-A and/or I-V concerning the Listing of Shares and Equity Securities Other Than Shares Issued by Listed Companies, including the exclusion of share ownership by the Controlling Shareholder and its Affiliates; affiliates of beneficial owner; members of the Board of Commissioners or the Board of Directors; and treasury shares repurchased by the Company. The Board of Directors of PT UBC Medical Indonesia Tbk, on behalf of the Company, bears full responsibility for the information contained in this document. The Company hereby announce Monthly Report of Securities Holders Registration which ends in Agustus - 2026 Security Administration Bureau: PT. Bima Registra
Page 11
Number of Percent of Number of Percent of Affiliate of
Name Address Position Shares in Shares in Shares in Shares in Controller the
Previous Previous Current Current Controller
FX Yoshua Kawasan Direksi 0 0% 0 0%
Raintjung Industri
Pulogadung, Jl.
Rawa Gelam V,
Blok L, No Kav
X
11-13, Kel.
Jatinegara, Kec.
Cakung, Jakarta
Timur, Jakarta,
13930
Nathan Tirtana Kawasan Komisaris 0 0% 0 0%
Industri
Pulogadung, Jl.
Rawa Gelam V,
Blok L, No Kav
X
Board of 11-13, Kel.
Directors and Jatinegara, Kec.
Board of Cakung, Jakarta
Commission Timur, Jakarta,
13930
ers
Yudha Kawasan Direksi 0 0% 0 0%
Indrawirawan Industri
Pulogadung, Jl.
Rawa Gelam V,
Blok L, No Kav
11-13, Kel.
Jatinegara, Kec.
Cakung, Jakarta
Timur, Jakarta,
13930
Suyanto Kawasan Komisaris 0 0% 0 0%
Industri
Pulogadung, Jl.
Rawa Gelam V,
Blok L, No Kav
11-13, Kel.
Jatinegara, Kec.
Cakung, Jakarta
Timur, Jakarta,
13930
Page 12
Number of Percent of Number of Percent of Affiliate of
Name Address Shares in Shares in Shares in Shares in Controller the
Previous Previous Current Current Controller
Shareholders
of 5% (five PT Optel Ruko De 2,859,428,400 72.39% 2,859,428,40 72.39%
Investama Mansion Blok 0
percent) or
more E no.7 Alam
Sutera, 15143 X
Kota
Tangerang
Banten
Share Ownership of <5%
260.000.000 6,58% 260.000.00 6,58%
Share Ownership of <5% - Scrip 0
830.571.600 21,03% 812.571.60 20,57%
Share Ownership of <5% - Scripless 0
0 0% 18.000.000 0.46%
Treasury Stock
3.950.000.00 100% 3.950.000.00 100%
Total 0 0
Page 13
Number of Scrip and Scripless Shares based on Investor Type and Classification Investor Type & Classification Number of Shares Affiliation from Controller 130.000.000 BOD / BOC 0 Employee (lock up shares only) 0 Controller 2.859.428.400 Treasury 18.000.000 Number of Scripless Shares based on Investor Type and Classification from KSEI Investor Type & Classification Number of Shares Bank 200 Government - Private Equity 117.646.900 Trustee Bank - Venture Capital - Private Bank - Exchange Traded Funds - Investment Manager - Investment Advisors 910.100 Brokerage Firms -
Page 14
Hedge Fund - Sovereign Wealth Fund - Capital Market Supporting Institutions and Professions - Commanditaire Vennootschap (CV) or Limited partnership 57.977.600 Firm - Investment Fund Selling Agent - Peer to peer lending - Permanent establishment - Sole proprietorship - Corporate 250.050.700 Association/social organizations - State Owned Enterprises - Central Bank - State Owned Company - Diocese - Conference - Congregation - Cooperatives - International organization - Political parties -
Page 15
Partnership - Educational Institution - Mutual Funds (MF) - Securities Company (SC) - Pension Funds (PF) - Financial Institutional (IB) - Insurance (IS) - Foundation (FD) - Individual (ID) 403.986.100 *The investor classification data presented in this report is derived from information provided by KSEI Account Holders based on verification conducted through the Know Your Customer (KYC) process on the investor data under their management. The determination of investor classification is carried out by each KSEI Account Holder with reference to the definitions and investor classification guidelines provided by KSEI. The accuracy and appropriateness of the investor classification presented in this report remain the responsibility of each KSEI Account Holder that performs the classification process.
Page 16
Free Float Share Information
Information Previous Month This Month
The number of scripless shares owned by shareholders is less
830.571.600 812.571.600
than 5%
The number of scripless shares owned by the Board of Directors
0 0
and Board of Commissioners is less than 5%
The number of scripless shares owned by the Controller is less
0 0
than 5%
The number of scripless shares owned by Affiliates of the 0 0
Controller is less than 5%
The amount of scripless treasury stock is less than 5% 0 18.000.000
The number of shares owned less than 5% and subject to a lock-
up restriction, either based on regulations or the corporate 0 0
actions of the listed company.
The number of non-script shares owned less than 5% by venture 117.646.900 117.646.900
capital and private equity companies
The number of non-script shares owned less than 5% and 0 0
subject to confiscation or blocking by law enforcement officials or
authorized authorities.
Number of shares with public investor beneficiaries that have 0 0
been approved by IDX as Free Float (Provision V.2 of Regulation
I-A and Provision V.2 of Regulation I-V).
The amount of Free Float Share 712.924.700 676.924.700
The number of shares listed on the Exchange at the end of the
3.950.000.000 3.950.000.000
month
% Free Float Share 18,05 17,14
Page 17
Remarks Previous Month Previous Month Percentage Current Month Current Month Percentage
Number of Unlisted Shares 0 0% 0 0%
Number of Shareholders Holding SID Accounts
Previous Month Current Month Change
2.595 2.308 287
Beneficial owner (ultimate individual controller) consisting of one party or an organized group from PT UBC
Medical Indonesia Tbk
Company’s Direct Direct Shareholder % Share
Number Beneficial Owner Name Address
Shareholders Name Ownership*
1 Nathan Tirtana Kawasan Industri Pulogadung, Jl. No PT Optel Investama 72,39 %
Rawa Gelam V, Blok L, No Kav 11-13, Mulia
*Ownership Percentage, if the “Direct Shareholder” column is filled:
- Yes: represents the % ownership of the beneficial owner directly in the Company
- No: represents the % ownership of the direct shareholder in the Company
Thus to be informed accordingly.
Respectfully,
PT UBC Medical Indonesia Tbk
Page 18
Franciscus Xaverius Yoshua Raintjung
Direktur Utama
PT UBC Medical Indonesia Tbk
Kawasan Industri Pulogadung, Jl. Rawa Gelam V, Blok L, No Kav 11-13, Kel.
Phone : 021-38865110, Fax : , www.ubcindonesia.com
Sender Name Franciscus Xaverius Yoshua Raintjung
Function Direktur Utama
Date and Time 09-09-2026 10:58
Attachment 1. 2026.09.08_UBC_SP MONTHLY REPORT_COMPLETE.pdf
2. 1_BEI E-Reporting LABS Per Agustus 2026.pdf
This is an official document of PT UBC Medical Indonesia Tbk that does not require a signature as it was generated
electronically by the electronic reporting system. PT UBC Medical Indonesia Tbk is fully responsible for the
information contained within this document.
Names mentioned 10 people and organisations named in the text · linked when the evidence is strong
unresolved
org
PT. Bima Registra
· Biro Administrasi Efek
p.1 ×2
unresolved
org
PT Optel
p.3 ×2
unresolved
—
Franciscus Xaverius Yoshua Raintjung
· Direktur Utama
p.9 ×6
unresolved
—
FX Yoshua
· Direksi
p.11
unresolved
—
Yudha
· Direksi
p.11
unresolved
person
Function
· Direktur Utama
p.18
Extraction attempts how the parser did, and what it refused
Nothing structured was extracted from this document — the attempts below say why.
Rule parser
OK
confidence 0.900
232 ms
12 Sep 2026 21:39
Raw output
{'aggregates': {'total': {'pct': '100', 'shares': '3950000000'},
'treasury': {'pct': '0.46', 'shares': '18000000'},
'under5_non_warkat': {'pct': '20.57', 'shares': '812571600'},
'under5_warkat': {'pct': '6.58', 'shares': '260000000'}},
'as_of_date': '2026-08-31',
'checksum_ok': True,
'checksum_parts': '3950000000',
'holders': [{'address': 'Kawasan Industri Pulogadung, Jl. Rawa Gelam V, Blok '
'L, No Kav',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': True,
'name': 'FX Yoshua Raintjung',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Direksi',
'seq': 0,
'shares': '0',
'shares_prev': '0'},
{'address': '11-13, Kel. Jatinegara, Kec. Cakung, Jakarta Timur, '
'Jakarta, 13930 Kawasan Industri Pulogadung, Jl. Rawa '
'Gelam V, Blok L, No Kav',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': True,
'name': 'Nathan Tirtana',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Komisaris',
'seq': 1,
'shares': '0',
'shares_prev': '0'},
{'address': '11-13, Kel. Jatinegara, Kec. Cakung, Jakarta Timur, '
'Jakarta, 13930 Kawasan Industri Pulogadung, Jl. Rawa '
'Gelam V, Blok L, No Kav',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'Yudha Indrawirawan',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Direksi',
'seq': 2,
'shares': '0',
'shares_prev': '0'},
{'address': '11-13, Kel. Jatinegara, Kec. Cakung, Jakarta Timur, '
'Jakarta, 13930 Kawasan Industri',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'Suyanto',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Komisaris',
'seq': 3,
'shares': '0',
'shares_prev': '0'},
{'address': 'Ruko De Mansion Blok no.7 Alam Sutera, 15143 Kota '
'Tangerang Banten',
'category': 'FIVE_PCT',
'is_controller': True,
'is_controller_affiliate': False,
'name': 'PT Optel Investama',
'page_no': 3,
'pct': '72.39',
'pct_prev': '72.39',
'position': '',
'seq': 4,
'shares': '2859428400',
'shares_prev': '2859428400'}],
'issuer_name': 'PT UBC Medical Indonesia Tbk',
'issuer_ticker': 'LABS',
'layout': 'EREP_COVER',
'letter_number': '042/CS-MM/LABS/IX/26',
'listing_board': 'Pengembangan',
'period_label': 'Agustus 2026',
'registrar': 'PT. Bima Registra',
'total_shares': '3950000000'}