Nomor Surat
SB-022/FM-CSL/BEI/IV/2017
Nama Emiten
First Media Tbk
Kode Emiten
KBLV
Lampiran
1
Perihal
Laporan Bulanan Registrasi Pemegang Efek
Perseroan menyampaikan Laporan Bulanan Registrasi Pemegang Efek First Media Tbk yang berakhir pada bulan 31 Maret 2017
sebagai berikut:
Biro Administrasi Efek PT. Sharestar Indonesia
Nama
Pemegang saham > 5%
Alamat
AcrossAsia Ltd (dalam pail PT Reksa Puspita Karya
Jumlah Persen Saham Saham Sebelumnya Sebelumnya
PO Box 309 Ugland House, 959,976,602 South Church Gd. BeritaSatu Plaza Lt.3 Jl. 588,167,378 Jend.Gatot
Masyarakat
194,023,927
Jumlah Persen Saham Saham Bulan Pengendali Bulan Ini Ini
55.1 959,976,60
55.1
33.76 588,167,37
33.76
11.14 194,023,927
11.14
100 1,742,167,90
100
Pemegang saham < 5% Saham Treasury
0
Total
1,742,167,90
Laporan Kepemilikan Saham Oleh Direksi dan Komisaris Nama
Jabatan
Alamat
Jumlah Saham Bulan Sebelumnya
Persen Saham Bulan Sebelumnya
Jumlah Saham Bulan Ini
Persen Saham Bulan Ini
Kepemilikan saham selain Pemegang Saham Pengendali dan Pemegang saham utama Jumlah Saham Bulan Sebelumnya
Persen Saham Bulan Sebelumnya
Jumlah Saham Bulan Ini
Persen Saham Bulan Ini
194,023,927
11.14
194,023,927
11.14
Jumlah Perubahan Persen Perubahan Saham 0
0
Jumlah Pemegang Saham Bulan Sebelumnya
Bulan ini 315
Jumlah Perubahan 317
2
Waran Nama
Alamat
Jumlah Waran Persen Waran Jumlah Waran Persen Waran Bulan Bulan Bulan Ini Bulan Ini Sebelumnya Sebelumnya
Jumlah Perubahan Waran
Informasi Lain
Nama Pengirim
Harianda Noerlan
Jabatan
Corporate Secretary
Tanggal dan Jam
10 April 2017 15:21:12
Lampiran
Surat Laporan Registrasi Pemegang Efek (Mar 17).pdf Dokumen ini merupakan dokumen resmi
First Media Tbk
yang tidak memerlukan tanda tangan karena dihasilkan secara elektronik oleh sistem pelaporan secara elektronik. First Media Tbk bertanggung jawab penuh atas informasi yang tertera di dalam dokumen ini.
LAMPIRAN : 1 KEPEMILIKAN EFEK YANG MENCAPAI 5% ATAU LEBIH DARI SAHAM YANG DITEMPATKAN DAN DISETOR PENUH EMITEN : PT FIRST MEDIA TBK B A E : PT SHARESTAR INDONESIA MODAL DISETOR : 1,742,167,907 SAHAM PER TANGGAL 31 M A R E T 2017 ---------------------------------------------------------------------------------------------------------------------------------|NO| D A T A |KEBANGSAAN| J U M L A H S A H A M | % KEPEMILIKAN | | | PEMEGANG SAHAM | |-----------------------------------------|--------------------| | | | | BULAN LALU | BULAN INI |BULAN LALU|BULAN INI| |--|---------------------------------------------------|----------|--------------------|--------------------|----------|---------| | 1| ACROSSASIA LIMITED |LEMBAGA | 959,976,602| 959,976,602| 55.10 | 55.10 | | | PO BOX 309, UGLAND HOUSE, SOUTH CHURCH |ASING | | | | | | | STREET GEORGE TOWN, GRAND CAYMAN CAYMAN | | | | | | | | ISLANDS, BRITISH WEST INDIES | | | | | | | | | | | | | | | 2| REKSA PUSPITA KARYA,PT |LEMBAGA | 550,167,378| 550,167,378| 31.58 | 31.58 | | | BERITASATU PLAZA LT.7 JL. GATOT SUBROTO |INDONESIA | | | | | | | KAV 35-36, SETIABUDI | | | | | | | | | | | | | | | | REKSA PUSPITA KARYA, PT |LEMBAGA | 38,000,000| 38,000,000| 2.18 | 2.18 | | | JL. WOLTER MONGONSIDI 24 A, |INDONESIA | | | | | | | PETOGOGAN KEBAYORAN BARU | | | | | | | | JAKARTA SELATAN 12170 | | | | | | | | | | | | | | ---------------------------------------------------------------------------------------------------------------------------------JAKARTA, 03 A P R I L 2017 PT SHARESTAR INDONESIA
PT FIRST MEDIA Tbk KEPEMILIKAN SAHAM OLEH DIREKSI/KOMISARIS PER 31/03/2017 HALAMAN: 1 ----------------------------------------------------------------------------------------------------------------------------------NOMOR NAMA PEMEGANG SAHAM JUMLAH SAHAM % JUMLAH SAHAM % JUMLAH SAHAM % SEBELUMNYA BULAN INI PERUBAHAN -----------------------------------------------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------------------------T O T A L : 0 0.00 0 0.00 0 0.00 -----------------------------------------------------------------------------------------------------------------------------------
English Translation Letter No. Company’s Name Stock Code Attachment Subject
SB-022/FM-CSL/BEI/IV/2017 First Media Tbk KBLV 1 Monthly Report of Registration of Shareholders
The Company submit Monthly Report of Registration of Shareholders of First Media Tbk ended March 31, 2017 as follows: Securities Administration Bureau: PT Sharestar Indonesia Name
Share Ownershop > 5%
Address
PT AcrossAsia Ltd (in bankruptcy)
PT Reksa Puspita Karya
Share Ownership < 5%
P.O. Box 309, Ugland House, South Church Street, George Town, Grand Cayman, Cayman Islands, British West Indies Gedung Citra Graha LT.3 Jl. Jend. Gatot Subroto Kav.35-36, Jakarta Selatan DKI Jakarta 12950
Public
Treasury Shares Total
Number of Shares on the Previous Month
Percentage of Shares on the Previous Months
Number of Shares of this Month
Percentage of Shares of this Month
Controlling
959,976,602
55.1
959,976,602
55.1
[_]
588,167,378
33.76
588,167,378
33.76
[_]
194,023,927
11.14
194,023,927
11.14
[_]
1,742,167,907
100
1,742,167,907
100
Report of Share Ownership by Directors and Commissioners Percentage of Shares on the Previous Months
Number of Shares of this Month
Percentage of Shares of this Month
Share Ownership besides the Controlling Shareholder and Majority Shareholders Percentage of Shares Number of Shares on Number of Shares of Percentage of Shares on the Previous the Previous Month this Month of this Month Month 194,023,927 11.14 194,023,927 11.14
Number of Changes
Percentage of Changes
0
0
Name
Address
Number of Shares on the Previous Month
Number of Shareholders Previous Month 315
This Month 317
Changes 2
Warrants Name
Address
Number of Warrants on the Previous Month
Percentage of Warrants on the Previous Month
Number of Warrants of this Month
Percentage of Warrants of this Month
Number of Changes
[_] Other Information Sender Position Date and Time Attachment
Harianda Noerlan Corporate Secretary April 10, 2017 15:21:12 Surat Laporan Registrasi Pemegang Efek (Mar 17).pdf
This document is an official document of First Media Tbk which does not require any signature do to electronically generated by the electronic reporting system. First Media Tbk takes full responsibility for the information contained in this document.
ENGLISH Translation
No Letter:
SB-022/FM-CSL/BEI/IV/2017
Jakarta, April 10, 2017
To Directors of Indonesian Stock Exchange Company Indonesian Stock Exchange Building Jl. Jend. Sudirman Kav.52-53 Jakarta 12190 Attn: Mr. Samsul Hidayat Director of Companies Appraisal
Subject: Monthly Report of Registration of Shareholders Dear Sir, In connection with the provisions III.3.4 and III.3.5 Indonesia Stock Exchange Regulation Decisions of Directors of Indonesia Stock Exchange Company Number: Kep-306/BEJ/07-2004 dated July 19, 2004 about Regulation Number I-E about Information Delivery Obligations, with this PT First Media Tbk submit a March 2017 report about the activities of the registration the shareholder as of the date as follows: A. SHARE The Shareholders Own 5% or more shares have been issued and fully paid: 1. Name AcrossAsia Ltd (in bankruptcy) P.O. Box 309, Ugland House, South Church Street Address
George Town, Grand Cayman, Cayman Islands, British West Indies
2
Month Number of Shares Percent Shares Number of Shares Changes Percent Change Controlling Shareholders Name Address Month Number of Shares Percent Shares Number of Shares Changes Percent Change Controlling Shareholders
Previous month 959,976,602 55.10%
This month 959,976,602 55.10% 0 0% -
PT Reksa Puspita Karya Jl. Wolter Monginsidi 24A, Kel. Petogogan, RT.001/06, Kebayoran Baru, Jakarta Selatan 12170
Previous month 588,167,378 33.76%
This month 588,167,378 33.76% 0 0% -
Shares Ownership below 5% Number of Shares Share Changes Share Percent Change
Previous month 194,023,927 11.14%
This month 194,023,927 11.14% 0 0%
ENGLISH Translation
Number of Shareholders Previous Month 315
This Month 317
Changes 2
Thank you for your attention. Regards, PT FIRST MEDIA Tbk On behalf of Directors
Harianda Noerlan Director and Corporate Secretary
Cc: - Chief Executive of the Capital Market Supervisory, Financial Services Authority
English Translation
ATTACHMENT : 1 THE SECURITIES OWNERSHIP THAT REACHES 5% OR MORE OF THE ISSUED AND FULLY PAID SHARES ISSUERS BAE (Securities Administration Bureau) PAID-UP CAPITAL
: PT FIRST MEDIA TBK : PT SHARESTAR INDONESIA : 1,742,167,907 SHARES ST
AS OF MARCH 31 , 2017 NUMBER OF SHARES NO.
1
SHAREHOLDERS DATA
ACROSSASIA LIMITED P.O. BOX 309, UGLAND HOUSE, SOUTH CHURCH STREET, GEORGE TOWN, GRAND CAYMAN, CAYMAN ISLANDS, BRITISH WEST INDIES, CAYMAN ISLANDS
2
PT REKSA PUSPITA KARYA BERITASATU PLAZA LT.7 JL. GATOT SUBROTO KAV 35-36, SETIABUDI REKSA PUSPITA KARYA, PT JL. WOLTER MONGINSIDI 24 A, PETOGOGAN KEBAYORAN BARU JAKARTA SELATAN 12170
NATIONALITY
PREVIOUS MONTH
THIS MONTH
FOREIGN INSTITUTION
959,976,602
INDONESIA INSTITUTION
INDONESIA INSTITUTION
% SHAREHOLDING PREVIOUS MONTH
THIS MONTH
959,976,602
55.10
55.10
550,167,378
550,167,378
31.58
31.58
38,000,000
38,000,000
2.18
2.18
RD
JAKARTA, APRIL 03 , 2017 PT SHARESTAR INDONESIA
English Translation PT FIRST MEDIA Tbk THE SECURITIES OWNERSHIP BY DIRECTORS/COMMISSIONERS PER 31/03/2017 NUMBER
NAME OF SHAREHOLDERS
TOTAL:
NUMBER OF SHARES PREVIOUS MONTH
0
%
0.00
PAGE: 1 NUMBER OF SHARES THIS MONTH
%
0
0.00
NUMBER OF SHARE CHANGES
%
0
0.00
English Translation FORM NUMBER: X.H.1-2
ATTACHMENT Regulation number
:2 : X.H.1
MONTHLY REPORT SHARE OWNERSHIP OF ISSUER OR PUBLIC COMPANIES AND RECAPITULATION OF REPORTS Name of Issuer or Public Company Name of Stock Administration Bureau Year
: PT FIRST MEDIA TBK : PT SHARESTAR INDONESIA : 2017
Tax No.: 01.707.304.0-054.000
Number of Results Elligible **)
Position End of Month CAPITAL Month 1 January February March April May June July August September October November December
Basic (Number of Shares) 2 3,300,000,000 3,300,000,000 3,300,000,000 -
Paid-up (Number of Shares) 3 1,742,167,907 1,742,167,907 1,742,167,907 -
Share Ownership ≥ 5% Number of Shareholde rs 4 2 2 2 -
Number of Shares 5 1,548,143,980 1,548,143,980 1,548,143,980 -
Share Ownership < 5% % Shareholding
Number of Shareholders
6
7 88.86 88.86 88.86
-
314 327 351 -
Number of Shares 8 194,023,927 194,023,927 194,023,927 -
% Shareholding
This Month
Total up to this Month
9
10
11
11,14 11,14 11,14
0 0 0
-
TH
JAKARTA, APRIL 04 , 2017 PT SHARESTAR INDONESIA SOEROTO Director Notes: *) filled the reported month **) Indonesian Government Regulation No.56 Year 2015 dated August 3rd, 2015 a. At least 40% (forty percent) of the total paid-up shares is recorded for trading on the stock exchanges in Indonesia; b. Shares refered to in paragraph a must be owned by at least 300 (three hundred) party; c. Each Party refered to in paragraph b may only have a share of less than 5% (five percent) of the total shares issued and fully paid; and d. The provisions refered to in paragraph a, b, and c must be met in a short time at least 183 (one hundred eighty three) calendar days within a period of 1 (one) Fiscal Year.
0 0 0 -
