SHARES OWNERSHIP POLICY OF THE BOARD OF COMMISSIONERS AND BOARD OF DIRECTORS OF PT CITATAH TBK (the COMPANY )
A. LEGAL BASIS 1. Law No. 40 of 2007 on Limited Liability Company. 2. Law No. 8 of 1995 on Capital Market. 3. Financial Services Authority Regulation Number 33/POJK.04/2014 on Board of Directors and Board of Commissioners of Issuers or Public Companies, as amended from time to time. 4. Financial Services Authority Regulation Number 11/POJK.04/2017 on Reporting of Shares Ownership or Shares Ownership Changes in Public Companies, as amended from time to time. B. REPORTING OBLIGATION The reporting obligation applies to: 1. Directors and Commissioners of the Company must report to FSA their direct or indirect ownership in such company and every change thereto (there are no thresholds of 5% and 0.5%, so even one share will trigger the reporting obligation). 2. Any shareholders who directly or indirectly own 5% or more shares in the Company, if there is a change of 0.5% or more from their initial ownership as a result of a single transaction or a series of transactions. C. DETAILS REPORT The report must be submitted using the FSA form as attached in Appendix I, containing the following details: a. Name, address and nationality of the Director/Commissioner/Shareholder; b. Name of the Company whose shares are owned by Director/ Commissioner/Shareholder; c. Number and percentage of shares, both before and after the transaction; d. Number of shares purchased or sold; e. Sale or purchase price; f. Date of transaction; g. Purpose of transaction; h. Status of ownership (i.e., direct or indirect). The report submitted to FSA may duplicate by FSA and made available to the public. D. REPORTING MECHANISM 1. Self-Reporting a. Directors or Commissioners shall submit report of shares changes of individual shares ownership directly to FSA. 2
b. Directors or Commissioners shall send copies of the reporting as referred to point a above to the Company (Attention Corporate Secretary) at the same day for documentation purposes. Appendix I: Form Reporting Shares Ownership or Shares Ownership Changes in Public Company 2. Reporting via Proxy a. Directors and Commissioners may report ownership or change of their shares via Specific Power of Attorney ( Proxy ) through the Corporate Secretary. b. Reporting as point a above, will conduct as follows: i. Submit proof of shares transactions no later than two (2) calendar days after the shares transaction is done; ii. Fill out the Proxy Form as specified in Attachment II, to be attached to the Reporting Form. The Proxy Form is only completed one (1) time if it has certain period; c. The Corporate Secretary will submit the change of ownership or change report to FSA. Attachment II: Form Reporting Shares Ownership or Shares Ownership Changes In Public Company via Proxy Attachment III: Power of Attorney E. TIMING OF REPORTING 1. Self-Reporting a. Directors or Commissioners must submit the change of ownership or change report at least three (3) working days from the date of the transaction. b. Directors or Commissioners must submit the change of ownership or change report to FSA no later than ten (10) calendar days from the date of the transaction. 3. Reporting via Proxy Reporting of the Directors, Commissioners through Proxy shall be submitted to OJK within five (5) calendar days from the date of transaction. 3
F. CLOSING This Policy may be updated if considered necessary by considering the provisions of applicable laws and regulations in Indonesia. This Policy came into force on 2 October 2017. ***** Under the Article 4 paragraph (3) of the Financial Services Authority Regulation No. 8/POJK.04.2015 on Web Site of Issuers or Public Companies, in the event there is any difference of interpretation between Indonesia language and foreign language in the disclosed information thus Indonesia language shall prevail. 4
APPENDIX I FORMAT LAPORAN KEPEMILIKAN ATAU SETIAP PERUBAHAN KEPEMILIKAN SAHAM PERUSAHAAN TERBUKA REPORTING SHARES OWNERSHIP OR SHARES OWNERSHIP CHANGES IN PUBLIC COMPANY FORMAT Jakarta, [***] No. : Lampiran : - Appendixes Perihal : Laporan Kepemilikan Atau Setiap Perubahan Kepemilikan Saham Perusahaan Terbuka Subject : Reporting Shares Ownership or Shares Ownership Changes in Public Company Kepada Yth./To. Otoritas Jasa Keuangan Gedung Soemitro Djojohadikusumo Jalan Lapangan Banteng Timur No. 2-4 Jakarta U.p.: Kepala Eksekutif Pengawas Pasar Modal Executive Chief of the Capital Market Supervisory Saya yang bertanda tangan di bawah ini: The undersigned below: Nama/Name : Alamat Lengkap : (nama jalan dan nomor)... Full Address Nomor Telepon :... Phone sesuai dengan Pasal... Peraturan Otoritas Jasa Keuangan Nomor... tentang Keterbukaan Informasi Pemegang Saham Tertentu, melapor bahwa saya telah memiliki saham Perusahaan Terbuka dengan rincian sebagai berikut: in accordance with Article... of the Financial Services Authority Regulation Number... concerning the Disclosure of Information of Certain Shareholders, reports that I have owned shares in a Public Company with the following details: 1. 2. 3. 4. Nama Perusahaan Terbuka Name of the Public Company Jumlah saham dan persentase kepemilikan sebelum dan setelah transaksi Number of shares and shareholding percentage before and after the transaction Jumlah saham yang dibeli atau dijual Number of purchased or sold shares Harga pembelian atau penjualan per saham Average purchase price per share 5
5. 6. 7. Tanggal transaksi Date of transaction Tujuan dari transaksi Purpose of transaction Status kepemilikan saham Status of shares ownership Langsung Tidak Langsung Penjelasan: (diisi informasi mengenai pemegang saham yang terdaftar dalam daftar pemegang saham untuk kepentingan pemilik manfaat) Demikian disampaikan, atas perhatiannya diucapkan terima kasih. Please be informed accordingly, thank you for your kind attention.... (Nama Jelas dan Tanda Tangan) (Name and Signature) Tembusan/Cc: 1. Kepala Divisi Pemantauan Emiten/Division Head of Public Company Supervisory 6
APPENDIX II FORMAT LAPORAN KEPEMILIKAN ATAU SETIAP PERUBAHAN KEPEMILIKAN SAHAM PERUSAHAAN TERBUKA YANG DISAMPAIKAN MELALUI KUASA REPORTING SHARES OWNERSHIP OR SHARES OWNERSHIP CHANGES IN PUBLIC COMPANY FORMAT VIA PROXY Jakarta, [***] No. : Lampiran : - Appendixes Perihal : Laporan Kepemilikan Atau Setiap Perubahan Kepemilikan Saham Perusahaan Terbuka Melalui Kuasa Subject : Reporting Shares Ownership or Shares Ownership Changes in Public Company Via Proxy Kepada Yth./To. Otoritas Jasa Keuangan Gedung Soemitro Djojohadikusumo Jalan Lapangan Banteng Timur No. 2-4 Jakarta U.p.: Kepala Eksekutif Pengawas Pasar Modal Executive Chief of the Capital Market Supervisory Dengan hormat, Sesuai dengan Pasal 4 Peraturan Otoritas Jasa Keuangan Nomor 11/POJK.04/2017 tentang Laporan Kepemilikan atau Setiap Perubahan Kepemilikan Saham Perusahaan Terbuka, maka berdasarkan Surat Kuasa No. [***] tanggal [***], bersama ini atas nama [**************], Presiden Komisaris/Komisaris/Direktur Utama/Direktur PT Citatah Tbk ( Perseroan ) melaporkan perubahan kepemilikan saham Perseroan miliknya, dengan rincian sebagai berikut: According to the Article 4 of the Financial Services Authority Regulation Number 11/POJK.04/2017 on Reporting of Shares Ownership or Shares Ownership Changes in Public Companies, hence based on the Power of Attorney No. [***] dated [***], hereby on behalf of [**************], President Commissioner/Commissioner/President Director/Director of PT Citatah Tbk (the Company ) reporting his/her changes of shareholding in the Company, with the following details: 1. 2. Nama Perusahaan Terbuka Name of the Public Company Jumlah saham dan persentase kepemilikan sebelum dan setelah transaksi Number of shares and shareholding percentage before and after the transaction PT Citatah Tbk Kepemilikan Saham Sebelum Transaksi: Number of shares and shareholding percentage before transaction: [***] lembar saham/shares. Kepemilikan Saham Setelah Transaksi: Number of shares and shareholding percentage after transaction: [***] lembar saham/shares.
3. 4. 5. 6. 7. Jumlah saham yang dibeli atau dijual Number of purchased or sold shares Harga pembelian atau penjualan per saham Average purchase price per share Tanggal transaksi Date of transaction Tujuan dari transaksi Purpose of transaction Status kepemilikan saham Status of shares ownership [***] lembar saham/shares [***] [***] Pribadi Private Langsung/Tidak Langsung Direct/Indirect Pelaporan ini dilaksanakan berdasarkan Surat Kuasa Khusus yang ditandatangani diatas meterai dan dilampirkan dalam pelaporan ini. This reporting is made according to the Power of Attorney which signed on the stamp duty and attached in this report. Demikian disampaikan, atas perhatiannya diucapkan terima kasih. Please be informed accordingly, thank you for your kind attention. Tanda tangan + Cap Perusahaan Signature + Company s Stamp [Name of Corporate Secretary] Corporate Secretary Tembusan/Cc: 1. Kepala Divisi Pemantauan Emiten/Division Head of Public Company Supervisory 8
APPENDIX III FORMAT SURAT KUASA KHUSUS POWER OF ATTORNEY FORMAT SURAT KUASA POWER OF ATTORNEY No. [***] Pada hari ini, tanggal [Masukkan tanggal, bulan, tahun], saya.. (selanjutnya disebut sebagai Pemberi Kuasa ) dalam hal ini bertindak dalam kapasitasnya sebagai. dan karenanya sah mewakili untuk dan atas nama PT Citatah Tbk, suatu perseroan terbatas yang didirikan berdasarkan hukum Negara Republik Indonesia, berdomisili di Jl. Prof. Dr. Satrio C4 No. 10, Kuningan Timur, Setiabudi, Jakarta Selatan, berdasarkan anggaran dasar Perseroan telah diubah seluruhnya untuk disesuaikan dengan Undang- Undang Nomor 40 Tahun 2007 tentang Perseroan Terbatas sebagaimana ternyata dalam Akta Pernyataan Keputusan Rapat Nomor 262 tanggal 19 Juni 2015 yang dibuat di hadapan Dr. Irawan Soerodjo, S.H., M.Si., Notaris di Jakarta, anggaran dasar tersebut terakhir diubah berdasarkan Akta Pernyataan Keputusan Rapat Nomor 106 tanggal 20 Januari 2017 yang dibuat di hadapan Dr. Irawan Soerodjo, S.H., M.Si., Notaris di Jakarta, dengan ini memberikan kuasa kepada: On this day, dated the... [Insert date, month, year], I... (hereinafter referred to as the Authorizer ) in this matter acting in his/her capacity as... of and as such representing and acting for and on behalf of PT Citatah Tbk, a public limited liability company established and existing under the Law of Republic of Indonesia, having its legal domicile in Jl. Prof. Dr. Satrio C4 No. 10, Kuningan Timur, Setiabudi, Jakarta Selatan, pursuant to which its articles of associations have been severally amended, with the entire amendment in compliance to Company Law No. 40 Year 2007 as contained in the Deed of Statement of Meeting Resolution No. 262 dated 19 June 2015 which made before Dr. Irawan Soerodjo, S.H., M.Si., Notary in Jakarta, with the latest amendment of article of associations as contained in Deed of Statement of Meeting Resolution No. 106 dated 20 January 2017 which made before Dr. Irawan Soerodjo, S.H., M.Si., Notary in Jakarta, hereby wish to grant a delegation of authority to: Nama : Name Jabatan : Corporate Secretary Position (selanjutnya disebut sebagai Penerima Kuasa ) (hereinafter referred to as the Authorized Person ) -------------------------------------------------------- KHUSUS ------------------------------------------------------ -----------------------------------------------------SPECIFICALLY ------------------------------------------------- Untuk bertindak untuk dan atas nama Pemberi Kuasa untuk memberikan pelaporan, melaksanakan, dan mengambil tindakan-tindakan yang dipandang perlu dan dibutuhkan sehubungan dengan setiap perubahan kepemilikan saham Pemberi Kuasa di Perseroan ke Otoritas Jasa Keuangan. To act for and on behalf of the Authorizer to report, carry out and take any necessary and required actions or measures in connection with every change of Authorizer s ownerships of the Company shares to the Indonesian Financial Services Authority.
Seluruh kuasa diberikan berdasarkan Peraturan Otoritas Jasa Keuangan No. 11/POJK.04/2017 tentang Laporan Kepemilikan Atau Setiap Perubahan Kepemilikan Saham Perusahaan Terbuka dan Kebijakan Kepemilikan Saham Oleh Direksi dan Dewan Komsaris PT Citatah Tbk. All powers and authorization granted under the Financial Services Authority Regulation No. 11/POJK.04/2017 on Report on Shares Ownership or Changes of Ownership of the Public Companies and referring to the Shares Ownership Policy of the Board of Commissioners and Board of Directors of PT Citatah Tbk. Surat Kuasa ini berlaku sejak tanggal yang disebutkan di atas sampai (tanggal-bulantahun). This Power of Attonery will take effect from the date set out above until (date-month-year). Pemberi Kuasa The Authorizer Penerima Kuasa The Authorized Person. Nama Lengkap Full Name. Corporate Secretary 10