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20260507_MIKA_Laporan Bulanan Registrasi Pemegang Efek//Perubahan Struktur Pemegang Saham_32078724.pdf
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Extracted text 17
Page 1
Go To English Page Nomor Surat 53/MIKA-V/2026 Nama Perusahaan PT Mitra Keluarga Karyasehat Tbk. Kode Emiten MIKA Papan Pencatatan Utama Lampiran 1 Perihal Laporan Bulanan Registrasi Pemegang Efek Bersama ini PT Mitra Keluarga Karyasehat 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 Mitra Keluarga Karyasehat Tbk. bertanggung jawab penuh atas informasi yang tertera didalam dokumen ini. Perseroan menyampaikan Laporan Bulanan Registrasi Pemegang Efek yang berakhir pada akhir bulan April - 2026 Sebagai Berikut : Biro Administrasi Efek: PT. Adimitra Jasa Korpora
Page 2
Persen
Jumlah Persen
Jumlah Saham Saham Afiliasi
Nama Alamat Jabatan Saham Bulan Saham Bulan Pengendali
Sebelumnya Sebelumny Pengendali
Ini Ini
a
Ir. Rustiyan Jakarta, Direksi 181.661.600 1,31% 181.661.600 1,31%
Oen, MBA Indonesia X
Jozef Jakarta, Komisaris 978.000 0,01% 978.000 0,01%
Darmawan Indonesia X
Shinta Indonesia Komisaris 0 0% 0 0%
Pemegang Deviyanti X
Saham
Isje Ayusari Indonesia Komisaris 0 0% 0 0%
Direksi dan X
Komisaris
I Gusti Gede Indonesia Komisaris 0 0% 0 0%
Subawa
Joyce Indonesia Direksi 0 0% 0 0%
Vidyayanti
Nurvantina Indonesia Komisaris 0 0% 0 0%
Pandina
Christina Dian Indonesia Direksi 0 0% 0 0%
Anggraeni
Persen
Jumlah Persen
Jumlah Saham Saham Afiliasi
Nama Alamat Saham Bulan Saham Bulan Pengendali
Pemegang Sebelumnya Sebelumny Pengendali
Ini Ini
saham 5% a
(lima persen) PT Griyainsani Jl. Letjen. 8.991.740.800 64,65% 8.991.740.80 64,65%
atau lebih Cakrasadaya Suprapto Kav 0
X
4Jakarta Pusat
10510
Pemegang Saham < 5%
0 0% 0 0%
Publik - Warkat
Page 3
4.732.270.40 34,025% 4.720.411. 33,94%
Publik - Non Warkat 0 000
830.700 0,005% 12.690.100 0.09%
Saham Treasuri
13.907.481.5 100% 13.907.481.5 100%
Total 00 00
Page 4
Jumlah Saham Non Warkat berdasarkan Tipe Investor
Tipe dan Klasifikasi Investor Jumlah Saham
Afiliasi dari pengendali dan pemilik manfaat 2.419.181.800
Direksi dan Dewan Komisaris 182.639.600
Karyawan (hanya saham yang dibatasi pengalihan
0
kepemilikannya)
Pengendali 8.991.740.800
Saham Tresuri 12.690.100
Jumlah Saham Scripless berdasarkan Tipe dan Klasifikasi Investor dari KSEI
Tipe dan Klasifikasi Investor Jumlah Saham
Bank 7.655.316
Government -
Private Equity 453.060.000
Trustee Bank 40.329.586
Venture Capital -
Private Bank 509.284.100
Exchange Traded Funds 89.009.557
Investment Manager 3.843.561
Investment Advisors 19.133.178
Brokerage Firms 17.224
Page 5
Hedge Fund 60.576.782 Sovereign Wealth Fund 343.203.773 Capital Market Supporting Institutions and Professions - Commanditaire Vennootschap (CV) or Limited partnership 210.000 Firm 9.148.842.900 Invesment Fund Selling Agent - Peer to peer lending - Permanent establishment - Sole proprietorship 9.300 Corporate 1.560.814.100 Association/social organization - State-owned enterprises 100 Central Bank 474.800 State Owned Company - Diocese - Conference - Congregation 308.000 Cooperatives 365.300 International organization 116.400 Political parties -
Page 6
Partnership - Educational Institution 711.900 Mutual Funds (MF) 569.963.211 Securities Company (SC) 2.236.771 Pension Funds (PF) 295.725.601 Financial Institutional (IB) 11.310.000 Insurance (IS) 503.468.200 Foundation (FD) 12.324.101 Individual (ID) 274.487.739 *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
4.915.740.700 4.915.740.700
saham kurang dari 5%
Jumlah saham non-warkat dimiliki oleh Direksi dan Dewan
182.639.600 182.639.600
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 2.419.181.800 2.419.181.800
kurang dari 5%
Jumlah saham tresuri non-warkat kurang dari 5% 830.700 12.690.100
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 0 0
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 2.313.088.600 2.301.229.200
Jumlah saham tercatat di Bursa per akhir bulan 13.907.481.500 13.907.481.500
% Saham Free Float 16,63 16,55
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
6.280 6.600 320
Pemilik manfaat (pengendali tingkat individu) yang terdiri dari satu pihak atau kelompok yang terorganisasi dari PT Mitra Keluarga
Karyasehat Tbk.
Pemegang Saham
Nama Pemegang % Kepemilikan
Nomor Nama Pemilik Manfaat Alamat Langsung
Saham Langsung Saham*
Perseroan
1 Poppy Hadiman Setiawan JAKARTA, Tidak PT Santa Seha 10,77 %
INDONESIA Sanadi
2 Gerda Veronica JAKARTA, Tidak PT Diptanala 10,77 %
INDONESIA Bahana
3 Franciscus Bing Aryanto JAKARTA, Tidak PT Bina Arta 10,77 %
INDONESIA Charisma
4 Theresia Harsini JAKARTA, Tidak PT Ladang Ira 10,77 %
INDONESIA Panen
5 Maria Karmila JAKARTA, Tidak PT Lucasta Murni 10,77 %
INDONESIA Cemerlang
6 Rustiyan Oen JAKARTA, Ya 1,31 %
INDONESIA
7 Santoso Oen JAKARTA, Tidak PT Gira Sole Prima 5,385 %
INDONESIA
8 Rustiyan Oen JAKARTA, Tidak PT Gira Sole Prima 5,385 %
INDONESIA
Page 9
* 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 Mitra Keluarga Karyasehat Tbk.
Joyce V. Handajani
Corporate Secretary
PT Mitra Keluarga Karyasehat Tbk.
Jl. Raya Gading Kirana Kav.2 Jakarta Utara 14240
Telepon : (021) 4585 2700, Fax : (021) 4585 2727, http://www.mitrakeluarga.com/
Nama Pengirim Joyce V. Handajani
Jabatan Corporate Secretary
Tanggal dan Waktu 07-05-2026 16:55
Lampiran 1. 5. MIKA - LAPORAN BULAN APRIL 2026.pdf
Dokumen ini merupakan dokumen resmi PT Mitra Keluarga Karyasehat Tbk. yang tidak memerlukan tanda tangan
karena dihasilkan secara elektronik oleh sistem pelaporan elektronik. PT Mitra Keluarga Karyasehat Tbk.
bertanggung jawab penuh atas informasi yang tertera didalam dokumen ini.
Page 10
Go To Indonesian Page Letter / Announcement No. 53/MIKA-V/2026 Issuer Name PT Mitra Keluarga Karyasehat Tbk. Issuer Code MIKA Listing Board Main Attachment 1 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 Mitra Keluarga Karyasehat 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 April - 2026 Security Administration Bureau: PT. Adimitra Jasa Korpora
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
Ir. Rustiyan Jakarta, Direksi 181,661,600 1.31% 181,661,600 1.31%
Oen, MBA Indonesia X
Jozef Jakarta, Komisaris 978,000 0.01% 978,000 0.01%
Darmawan Indonesia X
Board of Shinta Indonesia Komisaris 0 0% 0 0%
Deviyanti X
Directors and
Board of Isje Ayusari Indonesia Komisaris 0 0% 0 0%
Commission X
ers
I Gusti Gede Indonesia Komisaris 0 0% 0 0%
Subawa
Joyce Indonesia Direksi 0 0% 0 0%
Vidyayanti
Nurvantina Indonesia Komisaris 0 0% 0 0%
Pandina
Christina Dian Indonesia Direksi 0 0% 0 0%
Anggraeni
Number of Percent of Number of Percent of Affiliate of
Shareholders Name Address Shares in Shares in Shares in Shares in Controller the
of 5% (five Previous Previous Current Current Controller
percent) or PT Griyainsani Jl. Letjen. 8,991,740,800 64.65% 8,991,740,80 64.65%
more Cakrasadaya Suprapto Kav 0
X
4Jakarta
Pusat 10510
0 0% 0 0%
Public - Scrip
4.732.270.40 34,025% 4.720.411. 33,94%
Public - Scripless 0 000
830.700 0,005% 12.690.100 0.09%
Treasury Stock
13.907.481.5 100% 13.907.481.5 100%
Total 00 00
Page 12
Number of Scrip and Scripless Shares based on Investor Type and Classification Investor Type & Classification Number of Shares Affiliation from Controller & Beneficial Owner 2.419.181.800 BOD / BOC 182.639.600 Employee (lock up shares only) 0 Controller 8.991.740.800 Treasury 12.690.100 Number of Scripless Shares based on Investor Type and Classification from KSEI Investor Type & Classification Number of Shares Bank 7.655.316 Government - Private Equity 453.060.000 Trustee Bank 40.329.586 Venture Capital - Private Bank 509.284.100 Exchange Traded Funds 89.009.557 Investment Manager 3.843.561 Investment Advisors 19.133.178 Brokerage Firms 17.224
Page 13
Hedge Fund 60.576.782 Sovereign Wealth Fund 343.203.773 Capital Market Supporting Institutions and Professions - Commanditaire Vennootschap (CV) or Limited partnership 210.000 Firm 9.148.842.900 Investment Fund Selling Agent - Peer to peer lending - Permanent establishment - Sole proprietorship 9.300 Corporate 1.560.814.100 Association/social organizations - State Owned Enterprises 100 Central Bank 474.800 State Owned Company - Diocese - Conference - Congregation 308.000 Cooperatives 365.300 International organization 116.400 Political parties -
Page 14
Partnership - Educational Institution 711.900 Mutual Funds (MF) 569.963.211 Securities Company (SC) 2.236.771 Pension Funds (PF) 295.725.601 Financial Institutional (IB) 11.310.000 Insurance (IS) 503.468.200 Foundation (FD) 12.324.101 Individual (ID) 274.487.739 *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 15
Free Float Share Information
Information Previous Month This Month
The number of scripless shares owned by shareholders is less
4.915.740.700 4.915.740.700
than 5%
The number of scripless shares owned by the Board of Directors
182.639.600 182.639.600
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 2.419.181.800 2.419.181.800
Controller is less than 5%
The amount of scripless treasury stock is less than 5% 830.700 12.690.100
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 0 0
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 2.313.088.600 2.301.229.200
The number of shares listed on the Exchange at the end of the
13.907.481.500 13.907.481.500
month
% Free Float Share 16,63 16,55
Page 16
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
6.280 6.600 320
Beneficial owner (ultimate individual controller) consisting of one party or an organized group from PT Mitra
Keluarga Karyasehat Tbk.
Company’s Direct Direct Shareholder % Share
Number Beneficial Owner Name Address
Shareholders Name Ownership*
1 Poppy Hadiman Setiawan JAKARTA, INDONESIA No PT Santa Seha 10,77 %
Sanadi
2 Gerda Veronica JAKARTA, INDONESIA No PT Diptanala 10,77 %
Bahana
3 Franciscus Bing Aryanto JAKARTA, INDONESIA No PT Bina Arta 10,77 %
Charisma
4 Theresia Harsini JAKARTA, INDONESIA No PT Ladang Ira 10,77 %
Panen
5 Maria Karmila JAKARTA, INDONESIA No PT Lucasta Murni 10,77 %
Cemerlang
6 Rustiyan Oen JAKARTA, INDONESIA Yes 1,31 %
7 Santoso Oen JAKARTA, INDONESIA No PT Gira Sole Prima 5,385 %
8 Rustiyan Oen JAKARTA, INDONESIA No PT Gira Sole Prima 5,385 %
Page 17
*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 Mitra Keluarga Karyasehat Tbk.
Joyce V. Handajani
Corporate Secretary
PT Mitra Keluarga Karyasehat Tbk.
Jl. Raya Gading Kirana Kav.2 Jakarta Utara 14240
Phone : (021) 4585 2700, Fax : (021) 4585 2727, http://www.mitrakeluarga.com/
Sender Name Joyce V. Handajani
Function Corporate Secretary
Date and Time 07-05-2026 16:55
Attachment 1. 5. MIKA - LAPORAN BULAN APRIL 2026.pdf
This is an official document of PT Mitra Keluarga Karyasehat Tbk. that does not require a signature as it was
generated electronically by the electronic reporting system. PT Mitra Keluarga Karyasehat Tbk. is fully responsible
for the information contained within this document.
Names mentioned 24 people and organisations named in the text · linked when the evidence is strong
unresolved
org
PT. Adimitra Jasa Korpora
· Biro Administrasi Efek
p.1 ×2
unresolved
person
Ir. Rustiyan
p.2 ×2
unresolved
person
Oen
p.2 ×2
unresolved
org
PT Griyainsani
p.2 ×2
unresolved
org
PT Santa Seha
p.8 ×2
unresolved
org
PT Diptanala
p.8 ×2
unresolved
org
PT Bina Arta
p.8 ×2
unresolved
org
PT Ladang Ira
p.8 ×2
unresolved
org
PT Lucasta Murni
p.8 ×2
unresolved
person
Joyce V. Handajani
· Corporate Secretary
p.9 ×2
unresolved
—
Jozef
· Komisaris
p.11
unresolved
—
I Gusti Gede
· Komisaris
p.11
unresolved
—
Joyce
· Direksi
p.11
unresolved
—
Nurvantina
· Komisaris
p.11
unresolved
—
Christina Dian
· Direksi
p.11
unresolved
—
Santa Seha | 10,77 %
Sanadi
p.16
unresolved
—
Bina Arta | 10,77 %
Charisma
p.16
unresolved
—
Ladang Ira | 10,77 %
Panen
p.16
unresolved
—
Lucasta Murni | 10,77 %
Cemerlang
p.16
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
169 ms
12 Sep 2026 22:28
Raw output
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'treasury': {'pct': '0.09', 'shares': '12690100'},
'under5_non_warkat': {'pct': '33.94', 'shares': '4720411000'},
'under5_warkat': {'pct': '0', 'shares': '0'}},
'as_of_date': '2026-04-30',
'checksum_ok': True,
'checksum_parts': '13907481500',
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'category': 'BOARD',
'is_controller': False,
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'name': 'Rustiyan Oen, MBA',
'page_no': 2,
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'position': 'Direksi',
'seq': 0,
'shares': '181661600',
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{'address': 'Jakarta, Indonesia',
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'position': 'Komisaris',
'seq': 1,
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{'address': 'Indonesia',
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'is_controller_affiliate': True,
'name': 'Shinta Deviyanti',
'page_no': 2,
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'position': 'Komisaris',
'seq': 2,
'shares': '0',
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{'address': 'Indonesia',
'category': 'BOARD',
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'is_controller_affiliate': True,
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'position': 'Komisaris',
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{'address': 'Indonesia',
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{'address': 'Indonesia',
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'shares_prev': '0'},
{'address': 'Indonesia',
'category': 'BOARD',
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'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Komisaris',
'seq': 6,
'shares': '0',
'shares_prev': '0'},
{'address': 'Indonesia',
'category': 'BOARD',
'is_controller': False,
'is_controller_affiliate': False,
'name': 'Christina Dian Anggraeni',
'page_no': 2,
'pct': '0',
'pct_prev': '0',
'position': 'Direksi',
'seq': 7,
'shares': '0',
'shares_prev': '0'},
{'address': 'Jl. Letjen. Suprapto Kav 4Jakarta Pusat 10510',
'category': 'FIVE_PCT',
'is_controller': True,
'is_controller_affiliate': False,
'name': 'Griyainsani Cakrasadaya',
'page_no': 2,
'pct': '64.65',
'pct_prev': '64.65',
'position': '',
'seq': 8,
'shares': '8991740800',
'shares_prev': '8991740800'}],
'issuer_name': 'PT Mitra Keluarga Karyasehat Tbk.',
'issuer_ticker': 'MIKA',
'layout': 'EREP_COVER',
'letter_number': '53/MIKA-V/2026',
'listing_board': 'Utama',
'period_label': 'April 2026',
'registrar': 'PT. Adimitra Jasa Korpora',
'total_shares': '13907481500'}