20240305_ASDM_Laporan Informasi dan Fakta Material_31593263_lamp1.pdf

maka penyertaan meningkat menjadi 52.200 (lima puluh dua ribu dua-
ratus) saham dengan nilai penyertaan sebesar Rp52.200.000.000
(lima puluh dua miliar dua ratus juta Rupiah).

In the Extraordinary General Meeting of Shareholders of PT Eguity
Life Indonesia (ELI) which was held on March 1, 2024, Eli, an
associated entity of the Company with direct ownership of 15.4996,
the Company has obtained Bonus Shares originating from
Capitalization of unappropriated retained earnings as of date
December 31, 2022, with a ratio of 5 (five) old shares will receive 1
(one) bonus Share. Thus, the Company investment in ELI was
originally 43,500 (forty three thousand five hundred) shares with a
value of IDR 43,500,000,000 (forty three billion five hundred million
Rupiah) with the acguisition of 8,700 (eight thousand seven hundred)
Bonus Shares with nominal value of IDR 1,000,000 (one million
Rupiah) per share, which is obtained without payment, then the
investment increases to 52,200 (fifty two thousand two hundred)
Shares with an investment value of IDR 52,200,000,000 (fifty two
billion two hundred million rupiah)

Uraian Informasi
Atau Fakta Material
Description of
Material Information
or Fact

Dalam rangka memperkuat struktur permodalan Perusahaan
sebagaimana disyaratkan dalam ketentuan yang berlaku yang
mengatur kegiatan usaha ELI sebagai perusahaan asuransi jiwa serta
perundang-undangan yang berlaku. Dalam rangka penguatan
permodalan ELI, Perseroan telah menyetujui usulan ELI dalam Rapat
Umum Pemegang Saham Luar Biasa ELI untuk melakukan konversi
Saldo Laba dengan melakukan Kapitalisasi sebagian dari Saldo Laba
yang Belum ditetapkan penggunaannya per tanggal 31 Desember
2022 senilai Rp56.160.000.000 (lima puluh enam miliar seratus enam
puluh juta Rupiah) dengan menerbitkan 56.160 (lima puluh enam ribu
seratus enam puluh) saham baru dengan nilai nominal Rp1.000.000
(satu juta Rupiah) per saham. Saham hasil kapitalisasi Saldo Laba
tersebut akan dibagikan kepada para Pemegang Saham Perseroan
dengan rasio setiap 5 (lima) saham lama yang dimiliki oleh Pemegang
saham akan memperoleh 1 (satu) saham bonus.

In order to strengthen the Company's capital Structure as reguired by
the applicable provisions governing ELI's business activities as a life
Insurance company as well as applicable laws. In order to strengthen
ELI'S capital, the Company has approved ELI's proposal at the ELI
Extraordinary General Meeting of Shareholders to convert Retained
Earnings by capitalzing a portion of the unappropriated retained
earnings as of 31 December 2022 amounting to IDR 56, 160,000,000
(fifty-six billion one hundred and sixty million Rupiah) by issuing
56,160 (Ny six thousand one hundred and sixty) new Shares with a
nominal value of IDR 1,000,000 (one million Rupiah) per Share. The
Shares resulting from the capitalization of Retained Earnings will be
distributed to the Company's Shareholders with the ratio that for
every 5 (five) old shares owned by the Shareholders, they will receive
1 (one) bonus share.

“

PT ASURANSI DAYIN MITRA Tbk

General Insurance

Dengan demikian penyertaan Perseroan pada ELI meningkat dari
semula semula sebesar 43.500 (empat puluh tiga ribu lima ratus)
saham dengan nilai Rp43.500.000.000 (empat puluh tiga miliar lima
ratus juta Rupiah), dengan perolehan 8.700 (delapan ribu tujuh ratus)
Saham Bonus dengan nilai nominal Rp1.000.000 (satu juta Rupiah)
per saham, yang diperoleh tanpa pembayaran, maka penyertaan
meningkat menjadi 52,200 (lima puluh dua ribu dua ratus) saham
dengan nilai penyertaan sebesar Rp52.200.000.000 (lima puluh dua
miliar dua ratus juta Rupiah).

Dengan penerimaan Saham Bonus tersebut Perseroan akan
membukukan senilai Rp8.700.000.000 (delapan miliar tujuh ratus juta
Rupiah) sebagai penambahan jumlah investasi penyertaaan langsung
Perseroan terhadap ELI.

Thus, the Company's investment in ELI increased from the original
43,500 (forty three thousand five hundred) shares with a value of IDR
43,500,000,000 (forty three billion five hundred million Rupiah), with
the acguisition of 8700 (eight thousand seven hundred) Bonus
Shares with a nominal value of IDR 1,000,000 (one million Rupiah)
per Share, which is obtained without payment, then the investment
increases to 52,200 (Fifty two thousand two hundred) shares with an
investment value of IDR 52,200,000,000 (Fifty two billion two hundred
million Rupiah).

By receiving these Bonus Shares, the Company will record IDR
8700,000,000 (eight billion seven hundred million Rupiah) as an
additional amount of the Company 5 direct investment in ELI.

Keterangan tentang PT Eguity Life Indonsia

Information about PT Eguity Life Indonesia

ELI berkedudukan di Jakarta, didirikan berdasarkan Akta Perseroan
Terbatas No. 36 tertanggal 5 Desember 1986 dan Akta Perbaikan No.
143 tertanggal 26 Mei 1987, yang keduanya dibuat oleh dan di
hadapan Rachmat Santoso, S.H., Notaris di Jakarta, dan telah
mendapat persetujuan dari Menteri Kehakiman R.I. sebagaimana
dalam Surat Keputusannya tertanggal 15 Juni 1987 No. C2-
4266.HT.01.01.TH.87, dan Akta No 18 tertanggal 21 Oktober 1998
yang dibuat oleh Mudofir Hadi, S.H., Notaris di Jakarta, dan telah
mendapat persetujuan dari Menteri Hukum dan Perundang-Undangan
No. C-5664 HT.01.04.Th.2000 tertanggal 8 Maret 2000, dan Akta No.
7 tertanggal 10 April 2003 dan telah mendapatkan persetujuan dari
Menteri Kehakiman R.I sebagaimana dalam Surat Keputusannya No.
C-08056 HT.01.04.TH.2003 tertanggal 14 April 2003, serta Akta No.
16 tertanggal 28 April 2006 dan telah mendapatkan persetujuan dari
Menteri Hukum dan HAM R.I. sebagaimana dalam Surat
Keputusannya tertanggal 6 Juni 2006 No.  C-16402
HT.01.04.TH.2006, yang keduanya dibuat oleh dan di hadapan Isyana
W. Sadjarwo, S.H., serta perseroan telah menyesuaikan dengan
Undang-Undang (UU) Perseroan Terbatas No. 40 tahun 2007

w

PT ASURANSI DAYIN MITRA Tbk

General Insurance

sebagaimana dinyatakan dalam Akta No. 172 tertanggal 31 Juli 2008,
dibuat oleh dan di hadapan Hannywati Gunawan, S.H., Notaris di
Jakarta dan ditegaskan kembali dalam Akta Pernyataan Keputusan
Rapat No. 8 tertanggal 29 April 2009, yang dibuat oleh Isyana W.
Sadjarwo, S.H., Notaris di Jakarta yang telah mendapat persetujuan
dari Menteri Hukum dan HAM R.I sebagaimana dalam Surat
Keputusannya tertanggal 10 Juni 2009 No. AHU-25412.AH.01.02.
Tahun 2009, anggaran dasar Perseroan terakhir diubah berdasarkan
Akta Berita Acara Rapat Umum Pemegang Saham Luar Biasa Nomor:
345 tanggal 28 Desember 2022 yang dibuat oleh Hannywati
Gunawan, S.H., Notaris di Jakarta dan telah mendapat persetujuan
dari Menteri Hukum dan HAM R.I sebagaimana dalam Surat
Keputusannya tertanggal 24 Januari 2023 No.  AHU-
0004323.AH.01.02.TAHUN 2023 serta susunan Pengurus terakhir
Perseroan ditetapkan berdasarkan Akta Pernyataan Keputusan Rapat
Nomor: 164 tanggal 19 Juni 2023 yang dibuat oleh Hannywati
Gunawan, S.H., Notaris di Jakarta dan telah diterima dan dicatat di
dalam Sistem Administrasi Badan Hukum oleh Menteri Hukum dan
HAM R.I sebagaimana dalam Surat Keputusannya tertanggal 26 Juni
2023 No. AHU-AH.01.09-0132376.

ELI is domiciled in Jakarta, established based on Limited Liability
Company Deed No. 36 dated 5 December 1986 and Improvement
Deed no. 143 dated 26 May 1987, both of which were made by and
before Rachmat Santoso, S.H., Notary in Jakarta, and have received
approval from the Minister of Justice of the Republic of Indonesia. as
In his Decree dated 15 June 1987 No. C2-4266.HT.01.01.TH.87, and
Deed No. 18 dated 21 October 1998 made by Mudofir Hadi, S.H.,
Notary in Jakarta, and has received approval from the Minister of Law
and Legislation No. C-5664 HT.01.04.Th.2000 dated March 8 2000,
and Deed no. 7 dated 10 April 2003 and has received approval from
the Minister of Justice of the Republic of Indonesia as stated in his
Decree No. C-08056 HT.01.04.TH.2003 dated 14 April 2003, as well
as Deed No. 16 dated 28 April 2006 and has received approval from
the Minister of Law and Human Rights of the Republic of Indonesia.
as in his Decree dated 6 June 2006 No. C-16402 HT.01.04.TH.2006,
both of which were made by and in the presence of Isyana W.
Sadjarwo, S.H., and the company has adjusted to the Limited Liability
Company Law (UU) No. 40 of 2007 as stated in Deed no. 172 dated
31 July 2008, made by and before Hannywati Gunawan, S.H., Notary
In Jakarta and reaffirmed in the Deed of Meeting Decision Statement
No. 8 dated 29 April 2009, made by Isyana W. Sadjarwo, S.H., Notary
in Jakarta which has received approval from the Minister of Law and
Human Rights of the Republic of Indonesia as stated in his Decree
dated 10 June 2009 No. AHU-25412,AH.01.02, In 2009, the
Company's articles of association were last amended based on the
Deed of Minutes of the Extraordinary General Meeting of Shareholders
Number: 345 dated December 28, 2022 which was drawn up by
Hannywati Gunawan, S.H., Notary in Jakarta and received approval

H

PT ASURANSI DAYIN MITRA Tbk

General Insurance

Irom the Minister of Law and Human Rights of the Republic of.
Indonesia as stated in her Decree dated January 24, 2023 No. AHU-
0004323.AH.01.02.TAHUN 2023 and the final composition of the
Company's Management are determined based on the Deed of
Meeting Decision Statement Number: 164 dated 19 June 2023 which

was made by Hannywati Gunawan, S.H., Notary in Jakarta and has
been received and recorded in the Legal Entity Administration System

by the Minister of Law and Human Rights of the Republic of Indonesia

as stated in his Decree dated 26 June 2023 No. AHU-AH.01.09-

0132376.

Alamat Kantor / Office Address.

Sahid Sudirman Center Lt. 43

Jl. Jend. Sudirman No. 86

Jakarta 10220

No. Telp / Te/p. Number : 021 - 80868000
Email : contact.center@eguity.id

Website : www.eguity.co.id

jiatan ha / Busir A

Berdasarkan ketentuan Pasal 3 Anggaran Dasar ELI, maksud dan
tujuan ELI adalah berusaha dalam bidang Asuransi Jiwa Konvensional
(KBLI No. 65111) dengan melakukan kegiatan usaha jasa
penanggulangan risiko yang memberikan pembayaran kepada
pemegang polis, tertanggung atau pihak lain yang berhak dalam hal
tertanggung meninggal dunia atau tetap hidup atau pembayaran lain
kepada pemegang polis, tertanggung atau pihak lain yang berhak
pada waktu tertentu yang diatur dalam perjanjian yang besarnya
telah ditetapkan dan/atau didasarkan pada hasil pengelolaan dana.
Untuk mencapai maksud dan tujuan tersebut di atas, Perseroan dapat
melaksanakan kegiatan usaha tersebut sehubungan dengan
kesehatan (hea/th), pensiun dan jiwa (/ife) baik secara menyesuaikan
dengan perkembangan pun akan datang termasuk Insurance
Technology (/nsuretech), dan

Based on the provisions of Article 3 of ELI's Articles of Association,
ELI's aims and objectives are to operate in the field of Conventional
Life Insurance (KBLI No. 65111) by carrying out risk management
Service business activities that provide payments to policy holders,
Insurers or other entitled parties in the event that the insured dies or
survival or other payments to the policy holder, insured or other
entitled party at a certain time as regulated in the agreement. the
amount of which has been determined and/or is based on the results
Of fund management. To achieve the aims and objectives mentioned
above, the Company can carry out business activities related to
health, pensions and life, both in accordance with future
developments including insurance technology (Insurtech), and

PT ASURANSI DAYIN MITRA Tbk

General Insurance

Dana Pensiun Lembaga Keuangan Konvensional (KBLI 65321)
Kegiatan usaha Perseroan sehubungan dengan Dana Pensiun ini
meliputi penyelenggaraan program pensiun iuran pasti bagi
perorangan, baik karyawan maupun pekerja mandiri yang terpisah
dari dana pensiun pemberi kerja bagi karyawan Perseroan yang
bersangkutan.

Conventional Financial Institution Pension Fund (KBLI 65321)

The Company's business activities in relation to this Pension Fund
include the implementation of a defined contribution pension program
for individuals, both employees and selfemployed workers, which is
Seperate from the employers pension fund for the Companys

Sebelum Pembagian Saham Bonus / Setelah Pembagian Saham Bonus /
Before Distribution of Bonus Shares After Distribution of Bonus Shares
Jumlah Jumlah Nilai Jumlah Jumlah Nilai
Saham/ Nominal Yo Saham/ Nominal Yo
Total Rp1.000.000,- Total Rp1.000.000,-
Shares persaham/ Shares per saham/
Total Nominal Total Nominal
Value Value
IDR 1,000,000,- IDR 1,000,000,-
per share per share
Modal Dasar/Authorized | 900.000 | 900.000.000.000 - | 900.000 | 900.000.000.000 ha
capital
Modal Ditempatkan Dan
Disetor Penuh/ Isswed and
fully deposited capital
1. PT Eguity Development 173.720 173.720.000.000 61,87 | 208.464 208.464.000.000 61,87
Investment Tbk
2. PT Asuransi Dayin Mitra 43.500 43.500.000.000 15,49 52.200 52.200.000.000 1549
Tbk
3. PT Datindo Entrycom 33.100 33.100.000.000 11,79 39.720 39.720.000.000 11,79
4. PT Ventura Investasi 27.400 27.400.000.000 9,76 32.880 32.880.000.000 9,76
Prima
5. Ir Njudarsono Yusetijo 3.080 3.080.000.000 1,09 3.696 3.696.000.000 1,09
Jumlah Modal
Ditempatkan dan Disetor | 280.800 | 280.800.000.000 | 100,00 | 336.960 | 336.960.000.000 | 100,00
Penuh/ Total Issued
Capital and Fully Paid Up
Saham Dalam Portepel/ | 619.200 | 619.200.000.000 - | 563.040 | 563.400.000.000 -
Shares in Portfolio

Tujuan Transaksi/ Transaction Purpose

Perseroan selaku Pemegang Saham ELI mendukung rencana
penguatan permodalan ELI yang memiliki kegiatan usaha dalam

PT ASURANSI DAYIN MITRA Tbk

General Insurance

“4
1

bidang Asuransi Jiwa dengan mengkapitalisasi Saldo Laba Yang-
Belum ditetapkan Penggunaannya per 31 Desember 2022 menjadi
modal ditempatkan dan disetor penuh tanpa penyetoran dana kas
Perseroan ke ELI.

The Company as the Shareholder of ELI, supports the plan to
strengthen the capital of ELI which has business activities in the Life
Insurance sector by capitalizing the Unappropriated Retained
Earnings as of 31 December 2022 into issued and fully paid-up capital
without depositing the Company's cash funds to ELI.

4. | Dampak Kejadian,
Informasi atau Fakta
Material — Tersebut
Terhadap Kegiatan
Operasional Hukum,
Kondisi Keuangan,
Atau Kelangsungan
Usaha Emiten Atau
Perusahaan Publik

Impact of the event
or material
Information or fact
on the operations,
legal matters,
financial condition or
business continuity
Of the Issuer or
Public Company

Perseroan menerima Saham Bonus yang dibagikan oleh ELI sebesar
Rp8.700.000.000 (delapan miliar tujuh ratus juta Rupiah) yang
berasal dari kapitalisasi saldo laba dimana Perseroan tidak melakukan
penyetoran dana kas kepada ELI tetapi nilai penyertaan Perseroan
pada ELI meningkat sebesar Rp8.700.000.000 (delapan miliar tujuh
ratus juta Rupiah).

The Company received Bonus Shares which distributed by ELI in the
amount of IDR 8700,000,000 (eight billion seven hundred million
Rupiah) which came from the capitalization of retained earings
where the Company did not deposit cash funds to ELI but the value
Of the Company's investment in ELI increased by IDR 8,700,000,000
(eight billion seven hundred million Rupiah).

5. | Keterangan Lain
Other Information

Demikian laporan ini disampaikan dalam rangka Tfis report is submitted in order to comply with
memenuhi Peraturan Otoritas Jasa Keuangan Financial Services Authority Regulation Number
Nomor 31/POJK.04/2015 tentang Keterbukaan 31/POJK.04/2015 concerning Disclosure of
Informasi Atau Fakta Material Oleh Emiten atau Information or Material Facts by Issuers or Public

Perusahaan Publik.

Hormat kami, / Best Regards
1 PT Asuransi Dayin Mitra Tbk

z I-
Purnama Hadiwidjaja
Corporate Secretary

Companies.

PT ASURANSI DAYIN MITRA Tbk

General Insurance