Circular Letter No. 29/SEOJK.05/2016 Regarding the Form and Procedure for Applications, Submission of Reports, and Continuing Education Programs for Actuaries, Public Accountants, and Appraisers Conducting Activities in the Non-Bank Financial Industry

To:

1. Actuaries;
2. Public Accountants; and
3. Appraisers,
   At your place.

COPY

CIRCULAR LETTER OF THE FINANCIAL SERVICES AUTHORITY NUMBER 29 /SEOJK.05/2016

REGARDING

THE FORM AND PROCEDURE FOR APPLICATIONS, SUBMISSION OF REPORTS, AND CONTINUING EDUCATION PROGRAMS FOR ACTUARIES, PUBLIC ACCOUNTANTS, AND APPRAISERS WHO CONDUCT ACTIVITIES IN THE NON-BANK FINANCIAL INDUSTRY

In accordance with the mandate of Article 8 paragraph (5), Article 10 paragraph (4), Article 11 paragraph (4), Article 14 paragraph (5), and Article 16 paragraph (3) of Financial Services Authority Regulation Number 38/POJK.05/2015 concerning Registration and Supervision of Actuaries, Public Accountants, and Appraisers Who Conduct Activities in the Non-Bank Financial Industry (State Gazette of the Republic of Indonesia Year 2015 Number 361, Supplement to the State Gazette of the Republic of Indonesia Number 5807), it is necessary to regulate further regarding the form and procedure for registration applications, submission of reports, continuing education programs, the form and procedure for applications for approval of temporary suspension of services, the form and procedure for applications for reactivation of registered letters, as well as the form and procedure for applications for resignation of actuaries, public accountants, and appraisers in the Circular Letter of the Financial Services Authority as follows:

I. GENERAL PROVISIONS

In this Circular Letter of the Financial Services Authority, the following terms are defined:

1. Non-Bank Financial Institution (hereinafter referred to as LJKNB) is an institution that conducts activities in the insurance sector, pension funds, financing institutions, and other financial service institutions as referred to in Law Number 21 of 2011 concerning the Financial Services Authority, including those that conduct all or part of their business based on Sharia principles.

2. Non-Bank Financial Industry (hereinafter referred to as IKNB) is a financial industry consisting of LJKNB.

3. Actuary is an actuary who works at an actuarial consulting office and provides services in the IKNB sector.

4. Public Accountant is a public accountant as referred to in Law Number 5 of 2011 concerning Public Accountants and provides services in the IKNB sector.

5. Appraiser is a person who, with their expertise, conducts asset appraisal activities and provides services in the IKNB sector.

6. Continuing Education Program (hereinafter referred to as PPL) is a continuing professional education and/or training for Actuaries, Public Accountants, and Appraisers that is continuous and aims to maintain competence.

7. Financial Services Authority (hereinafter referred to as OJK) is the Financial Services Authority as referred to in Law Number 21 of 2011 concerning the Financial Services Authority.

II. FORM OF APPLICATION FOR REGISTRATION, APPROVAL OF TEMPORARY SUSPENSION OF SERVICES, REACTIVATION OF REGISTERED LETTER, AND RESIGNATION

1. The form of application for registration, approval of temporary suspension of services, reactivation of registered letter, and resignation of Actuaries, Public Accountants, and Appraisers is as follows:

a. for the application for registration of Actuaries, Public Accountants, and Appraisers using the format as referred to in Appendix I;

b. for the application for approval of temporary suspension of services at the request of Actuaries, Public Accountants, and Appraisers using the format as referred to in Appendix II;

c. for the application for reactivation of the registered letter of Actuaries, Public Accountants, and Appraisers using the format as referred to in Appendix III; and

d. for the application for resignation of Actuaries, Public Accountants, and Appraisers using the format as referred to in Appendix IV,

which is an integral part of this OJK Circular Letter.

2. In the event that the application as referred to in number 1 is approved, OJK will issue:

a. registered letter for the application for registration of Actuaries, Public Accountants, and Appraisers;

b. approval of temporary suspension of services for the application for approval of temporary suspension of services at the request of Actuaries, Public Accountants, and Appraisers;

c. notification letter for the application for reactivation of the registered letter of Actuaries, Public Accountants, and Appraisers; and

d. letter of cancellation of the registered letter for the application for resignation of Actuaries, Public Accountants, and Appraisers,

which shall be effective as of the date of establishment.

III. FORM AND TIME LIMIT FOR SUBMISSION OF REPORTS OF ACTUARIES, PUBLIC ACCOUNTANTS, AND APPRAISERS

1. Reports of Actuaries, Public Accountants, and Appraisers consist of periodic reports and ad hoc reports.

2. Reports of Actuaries, Public Accountants, and Appraisers as referred to in number 1 are prepared and signed by the Actuary, Public Accountant, or Appraiser who reports.

3. Periodic reports as referred to in number 1 consist of annual PPL reports.

4. Annual PPL reports as referred to in number 3 are submitted to OJK no later than February 15 of the following year.

5. Annual PPL reports as referred to in number 3 use the format as referred to in Appendix V which is an integral part of this OJK Circular Letter.

6. Ad hoc reports as referred to in number 1 consist of:

a. reports of changes in data and information; and

b. reports regarding violations of applicable laws and regulations in the financial services sector and/or at OJK carried out by LJKNB, as well as conditions or estimated conditions that may endanger the continuity of LJKNB business or stakeholders.

7. Reports of changes in data and information as referred to in number 6 letter a are submitted to OJK no later than 20 (twenty) working days since the occurrence of such changes.

8. Reports as referred to in number 6 letter b are submitted to OJK no later than 10 (ten) working days since the discovery of the following matters:

a. violations committed against applicable laws and regulations in the financial services sector and/or at OJK; and/or

b. matters that may endanger the continuity of LJKNB business or stakeholders.

9. Ad hoc reports as referred to in number 6 use the format as referred to in Appendix V which is an integral part of this OJK Circular Letter.

IV. CONTINUING EDUCATION PROGRAM (PPL)

1. Actuaries, Public Accountants, and Appraisers are required to participate in PPL.

2. PPL as referred to in number 1 is participated in by Actuaries, Public Accountants, and Appraisers every year.

3. PPL as referred to in number 1 is PPL organized by the Ministry of Finance, OJK, or a professional association recognized by the competent authority.

4. Actuaries, Public Accountants, and Appraisers registered with OJK must participate in PPL in the IKNB sector for at least 5 (five) Professional Credit Units (SKP) every year.

5. In the event that the number of SKP participated in one year is less than the regulation as referred to in number 4, then the respective Actuary, Public Accountant, or Appraiser is given the opportunity to increase the number of SKP in the implementation of PPL in the following year.

6. The opportunity to increase the number of SKP as referred to in number 5 is given in the event that there is an excess of SKP in the current year to cover the shortage of SKP in the previous year.

7. In the event that Actuaries, Public Accountants, and Appraisers do not participate in the opportunity provided as referred to in number 5, Actuaries, Public Accountants, and Appraisers are considered not to have participated in PPL in the relevant year.

8. In the event that fulfilling the obligation for PPL is a condition to obtain the registered letter as referred to in Article 14 paragraph (1) of OJK Regulation Number 38/POJK.05/2015 concerning Registration and Supervision of Actuaries, Public Accountants, and Appraisers Who Conduct Activities in the Non-Bank Financial Industry, then Actuaries, Public Accountants, and Appraisers must participate in PPL in the IKNB sector for at least 5 (five) SKP.

V. PROFESSIONAL ASSOCIATION

1. Professional associations as referred to in Section IV number 3 report the plan for the implementation of PPL to OJK which at least covers the syllabus, methods, and schedule of PPL to be implemented in 1 (one) year, no later than October 15 before the period of implementation of PPL.

2. Professional associations as referred to in Section IV number 3 submit the list of PPL participants' names and the number of SKP for the current 1 (one) year period, no later than January 31 of the following year to OJK.

3. The submission of the plan for the implementation of PPL as referred to in number 1 and the list of PPL participants' names and number of SKP as referred to in number 2 is addressed to:
   Financial Services Authority u.p. Director of Non-Bank Financial Industry Support Services

Menara Merdeka Building, 20th Floor
Jl. Budi Kemuliaan I No.2
Jakarta Pusat – 10110

4. OJK may conduct monitoring and evaluation of the implementation of PPL organized by professional associations as referred to in Section IV number 3.

VI. PROCEDURE FOR SUBMISSION OF APPLICATIONS AND REPORTS OF ACTUARIES, PUBLIC ACCOUNTANTS, AND APPRAISERS TO OJK

1. This Section regulates applications including applications for registration, applications for approval of temporary suspension of services, applications for reactivation of registered letters, and applications for resignation of Actuaries, Public Accountants, and Appraisers to OJK.

2. Applications and reports of Actuaries, Public Accountants, and Appraisers are submitted to OJK online through OJK's data communication network system.

3. In the event that OJK's data communication network system is not yet available, applications and reports of Actuaries, Public Accountants, and Appraisers are done in the form of computer printouts (hardcopy) and softcopy offline.

4. In the event that OJK experiences technical disturbances in OJK's data communication network system, OJK announces via OJK's website on the same day the technical disturbance occurs.

5. In the event that technical disturbances as referred to in number 4 occur, the submission of applications by Actuaries, Public Accountants, and Appraisers is done in the form of computer printouts (hardcopy) and softcopy offline.

6. In the event that technical disturbances as referred to in number 4 occur at the time limit for the submission of reports of Actuaries, Public Accountants, and Appraisers, the submission of reports of Actuaries, Public Accountants, and Appraisers is done in the form of computer printouts (hardcopy) and softcopy offline no later than the next working day.

7. The submission of applications and reports of Actuaries, Public Accountants, and Appraisers as referred to in number 5 and number 6 is done through a cover letter signed by the respective Actuary, Public Accountant, or Appraiser and addressed to:
   Financial Services Authority u.p. Director of Non-Bank Financial Industry Support Services Menara Merdeka Building, 20th Floor Jl. Budi Kemuliaan I No.2 Jakarta Pusat – 10110

8. The submission of applications and reports of Actuaries, Public Accountants, and Appraisers as referred to in number 7 is done by one of the following methods:

a. handed directly to the OJK office as referred to in number 7;

b. sent via registered post office; or

c. sent via a delivery/courier service company.

9. Actuaries, Public Accountants, and Appraisers are deemed to have submitted applications and reports of Actuaries, Public Accountants, and Appraisers with the following provisions:

a. for submission online through OJK's data communication network system, evidenced by a receipt from OJK; or

b. for submission via letter, evidenced by:

1) a receipt letter from OJK, if applications and reports are handed directly to the OJK office as referred to in number 8 letter a; or

2) a delivery receipt from the post office or delivery/courier service company, if applications and reports are sent via post office or delivery/courier service company as referred to in number 8 letter b and letter c.

10. In the event that there is a change in the OJK office address for the submission of reports as referred to in number 7, OJK will convey notification regarding the address change via letter or announcement.

VII. CLOSING

Provisions in this OJK Circular Letter shall take effect as of the date of establishment.

Established in Jakarta on July 25, 2016

EXECUTIVE HEAD OF SUPERVISOR OF INSURANCE, PENSION FUNDS, FINANCING INSTITUTIONS, AND OTHER FINANCIAL SERVICE INSTITUTIONS FINANCIAL SERVICES AUTHORITY, signed FIRDAUS DJAELANI

Copy matches the original
Director of Legal Affairs 1
Legal Department signed
Yuliana

APPENDIX I
CIRCULAR LETTER OF THE FINANCIAL SERVICES AUTHORITY NUMBER 29 /SEOJK.05/2016 REGARDING THE FORM AND PROCEDURE FOR APPLICATIONS, SUBMISSION OF REPORTS, AND ACTUARIES, PUBLIC ACCOUNTANTS, AND APPRAISERS WHO CONDUCT ACTIVITIES IN THE NON-BANK FINANCIAL INDUSTRY

APPLICATION FOR REGISTRATION
ACTUARIES, PUBLIC ACCOUNTANTS, AND APPRAISERS WHO CONDUCT ACTIVITIES IN THE NON-BANK FINANCIAL INDUSTRY

Format 1. Registration Application Letter
Format 2. Registration Application Form
Format 3. Curriculum Vitae
Format 4. Stamped Statement Letter Stating Never Having Committed Disgraceful Acts and/or Punished for Proven Commitment of Financial Crimes and Having No Bad Debts

Format 1: Registration Application Letter
…………………, …… …………………… ………
(To be filled with place, date, month, and year) Number :
Attachment :
Subject : Application for Registration of Actuary/Public Accountant/Appraiser *) To Yth. Financial Services Authority u. p. Director of Non-Bank Financial Industry Support Services Menara Merdeka Building, 20th Floor Jl. Budi Kemuliaan I No. 2 Jakarta – 10110

In accordance with the provisions of OJK Regulation Number 38/POJK.05/2016 concerning Registration and Supervision of Actuaries, Public Accountants, and Appraisers Who Conduct Activities in the Non-Bank Financial Industry, with this letter we apply to obtain the registered letter of Actuary/Public Accountant/Appraiser *) .

In this regard, we enclose the completed registration application form, along with other supporting documents.

Thank you for your attention.
Applicant,
(……………………………………….)
*) Strike out what is not appropriate

Format 2: Registration Application Form
FINANCIAL SERVICES AUTHORITY
NON-BANK FINANCIAL INDUSTRY SUPPORT SERVICES DIRECTORATE REGISTRATION APPLICATION FORM Profession applied for:
Actuary
Public Accountant
Appraiser

STATEMENT OF DATA AND INFORMATION TRUTH
I, the undersigned below:
Full Name : ………………………………………………………………….
Identity Number : ………………………………………………………………….

Hereby state, that the data and information submitted in the registration application form are true, and I have never been subject to the cancellation of the registered letter as an Actuary/Public Accountant/Appraiser *) from the Financial Services Authority.

This statement is made truthfully to be used as appropriate. If later this statement is not true, I am willing to be subject to the cancellation of the registered letter as an Actuary/Public Accountant/Appraiser *) from the Financial Services Authority and take responsibility for all consequences arising in accordance with applicable laws and regulations. …………………, ………………………… Maker of the statement, (stamp Rp 6,000,-) (……………………………………….) *) Strike out what is not appropriate

I. APPLICANT INFORMATION

1. Full Name : ………………………………………………….
2. Gender : Male
   Female
3. Identity Number : ………………………………………………….
4. Place and Date of Birth
   Place of Birth : ……………………………………………..
   Date of Birth : ……… - …………………… - …………..
5. Residential Address : ……………………………………………..
   RT/RW : ……………/ ……………
   Village : ……………………………
   District : ……………………………
   City : ……………………………
   Province : ……………………………
   Postal Code : ……………………………
6. Home Phone Number : ……………………………………………..
7. Mobile Phone Number : ……………………………………………..
8. E-mail : ……………………………………………..
9. Taxpayer Identification Number (NPWP) : ……………………………………………..
10. Ministry of Finance License Number : ……………………………………………..
11. Registered Letter Number :
    (OJK) (for those already registered in other sectors/formerly registered in the IKNB sector but resigned)
12. SIPO Information System User Code :
    (OJK Receipt) (accompanied by proof of payment for the name of the registered taxpayer)
13. Association Membership
    Association Name : ……………………………………………..
    Number : ……………………………………………..
    Valid until : ……… - …………………… - ………….

II. WORK EXPERIENCE INFORMATION

1. Name of KKA/KAP/KJPP : ……………………………………………..
2. KKA/KAP/KJPP Business License
   KMK No. : ……………………………………………..
   Date : ……… - …………………… - …………..
3. Last Position : ……………………………………………..
4. Other Work/Position : ……….…………………….
   other than at KKA/KAP/KJPP at
   Financial Service Institution
   Applicant,
   (……………………………………………)
   Supporting documents that must be submitted along with this form by the applicant *):
   Registration Application Letter
   Photocopy of Practice License from the Ministry of Finance ) Latest Signed Curriculum Vitae ) Photocopy of Final Formal Education Diploma ) Photocopy of Taxpayer Identification Number (NPWP) ) Photocopy of Training Program Certificate in the IKNB Sector Stamped Statement Letter Stating Never Having Committed Disgraceful Acts and/or Punished for Proven Commitment of Financial Crimes and Having No Bad Debts Photocopy of Registered Letter Issued by OJK (for those already registered with OJK other than in the IKNB sector) *) filled by OJK side ) not required to be attached for applicants already registered with OJK other than in the IKNB sector

Format 3: Curriculum Vitae
FINANCIAL SERVICES AUTHORITY
NON-BANK FINANCIAL INDUSTRY SUPPORT SERVICES DIRECTORATE CURRICULUM VITAE

I. APPLICANT DATA

1. Full Name : ………………………………………………
2. Place/Date of Birth : ………………………………………………
3. Residential Address : ………………………………………………
4. Mailing Address : ………………………………………………
5. Home Phone Number : ………………………………………………
6. Mobile Phone Number : ………………………………………………
7. Email : ………………………………………………
8. KKA/KAP/KJPP Address *)
   : ………………………………………………
   ………………………………………………
9. KKA/KAP/KJPP Phone *)
   : ………………………………………………

II. EDUCATION HISTORY

1. Formal Education
   In the column below, education history after High School or equivalent is recorded, and the highest education is mentioned first. Year Name of University/College Faculty and Department Level of Education

2. Non-Formal Education
   In the column below, only non-formal education relevant to the person's work is mentioned, and the most recent non-formal education is mentioned first. Year Name of Course/Training/Seminar Name of Organizer Location

III. WORK HISTORY
In the column below, work data is recorded, with the most recent mentioned first.
Year Position Name of Company/Institution

IV. WORK EXPERIENCE
In the column below, work experience data related to services provided in the IKNB sector based on employment contracts (most recent mentioned first) is recorded. No. Number, Date Report, and Scope Client Name Year Book Length of Work Days Hours Total ……………, …………………..………… Acknowledged, *) Leader/Partner ), KKA/KAP/KJPP *)…………………… (………………………………………….) Applicant, (………………………………………….) *) Not required to be filled for KKA/KAP/KJPP in the form of a sole proprietorship ) Strike out what is not appropriate

Format 4: Stamped Statement Letter Stating Never Having Committed Disgraceful Acts and/or Punished for Proven Commitment of Financial Crimes and Having No Bad Debts

STATEMENT LETTER
NEVER HAVING COMMITTED DISGRACEFUL ACTS AND/OR PUNISHED FOR PROVEN COMMITMENT OF FINANCIAL CRIMES AND HAVING NO BAD DEBTS

I, the undersigned below:
Full Name : ………………………………………………………………….
Identity Number : ………………………………………………………………….
Profession : ………………………………………………………………….

Hereby state truthfully that I have never committed disgraceful acts and/or been punished for proven commitment of financial crimes and have no bad debts.

This statement is made truthfully to be used as appropriate. If later this statement is not true, I am willing to be subject to the cancellation of the Registered Letter as an Actuary/Public Accountant/Appraiser *) from the Financial Services Authority and take responsibility for all consequences arising in accordance with applicable laws and regulations. …………………, ………………………… Maker of the statement, (stamp Rp 6,000,-) (……………………………………….) *) Strike out what is not appropriate

Established in Jakarta on July 25, 2016

EXECUTIVE HEAD OF SUPERVISOR OF INSURANCE, PENSION FUNDS, FINANCING INSTITUTIONS, AND OTHER FINANCIAL SERVICE INSTITUTIONS FINANCIAL SERVICES AUTHORITY, signed FIRDAUS DJAELANI

Copy matches the original
Director of Legal Affairs 1
Legal Department signed
Yuliana

APPENDIX II
CIRCULAR LETTER OF THE FINANCIAL SERVICES AUTHORITY NUMBER 29 /SEOJK.05/2016 REGARDING THE FORM AND PROCEDURE FOR APPLICATIONS, SUBMISSION OF REPORTS, AND ACTUARIES, PUBLIC ACCOUNTANTS, AND APPRAISERS WHO CONDUCT ACTIVITIES IN THE NON-BANK FINANCIAL INDUSTRY

APPLICATION FOR APPROVAL
TEMPORARY SUSPENSION OF SERVICES
ACTUARIES, PUBLIC ACCOUNTANTS, AND APPRAISERS WHO CONDUCT ACTIVITIES IN THE NON-BANK FINANCIAL INDUSTRY

Format 1. Application Letter for Temporary Suspension of Services at Own Request Format 2. Form for Temporary Suspension of Services at Own Request Format 3. Stamped Statement Letter Stating Not Currently in Contract with LJKNB

Format 1: Application Letter for Temporary Suspension of Services at Own Request …………………, …… …………………… ……… (To be filled with place, date, month, and year) Number :
Attachment :
Subject : Application for Temporary Suspension of Services for Actuary/Public Accountant/Appraiser *) To Yth. Financial Services Authority u. p. Director of Non-Bank Financial Industry Support Services Menara Merdeka Building, 20th Floor Jl. Budi Kemuliaan I No. 2 Jakarta – 10110

In accordance with the provisions of OJK Regulation Number 38/POJK.05/2016 concerning Registration and Supervision of Actuaries, Public Accountants, and Appraisers Who Conduct Activities in the Non-Bank Financial Industry, with this letter we apply for the temporary suspension of services for Actuary/Public Accountant/Appraiser *) .

In this regard, we enclose the completed Form for Temporary Suspension of Services at Own Request, along with other supporting documents.

Thank you for your attention.
Applicant,
(……………………………………….)
Registered Letter Number:
*) Strike out what is not appropriate

Format 2: Application Form for Temporary Suspension of Service Provision Upon Own Request FINANCIAL SERVICES AUTHORITY DIRECTORATE OF SUPPORT SERVICES FOR THE NON-BANK FINANCIAL INDUSTRY APPLICATION FORM FOR TEMPORARY SUSPENSION OF SERVICE PROVISION UPON OWN REQUEST Profession applying:
Actuarial Consultant
Public Accountant
Appraiser
STATEMENT OF DATA AND INFORMATION TRUTH
I, the undersigned:
Full Name : ………………………………………………………………….
Identity Number : ………………………………………………………………….
Hereby declare that the data and information submitted in this application form for temporary suspension of service provision upon own request are true. This statement is made truthfully for use as appropriate. If this statement is found to be untrue at a later date, I am willing to be accountable for all consequences arising in accordance with applicable legislation. …………………, ………………………… Person making the statement, (Stamp Duty Rp 6,000,-) (……………………………………….) STTD Number:

I. APPLICANT INFORMATION
1. Full Name : ………………………………………………….
2. Address During Suspension Period : ……………………………………………..
RT/RW : ……………/ ……………
Village/Sub-district : ……………………………
District : ……………………………
City : ……………………………
Province : ……………………………
Country : ……………………………
Postal Code : ……………………………
3. Registered Certificate Number :
(STTD) OJK
II. KKA/KAP/KJPP INFORMATION
1. Name of KKA/KAP/KJPP : ……………………………………………..
2. Business License of KKA/KAP/KJPP :
KMK No. : ……………………………………………..
Date : ……… - …………………… - …………..
3. Position at KKA/KAP/KJPP : Leader
Partner Leader
Partner
Other
III. INFORMATION ON TEMPORARY SUSPENSION OF SERVICE PROVISION
1. Reason for temporary suspension of service provision:
......................................................................................................................
......................................................................................................................
......................................................................................................................
......................................................................................................................
......................................................................................................................
......................................................................................................................
......................................................................................................................
......................................................................................................................
2. Duration requested : ……….. years ………… months

Applicant,
(………………………………………………)
STTD Number:
Supporting documents that must be submitted along with this form *) :
Application letter for temporary suspension of service provision upon own request Reason for temporary suspension of service provision upon own request (Section III, item 1) Stamped statement letter stating that the person is not currently in a contractual relationship with a Non-Bank Financial Institution (LJKNB) *) filled in by the OJK side

Format 3: Stamped Statement Letter Stating That the Person Is Not Currently in a Contractual Relationship with a Non-Bank Financial Institution STATEMENT LETTER NOT CURRENTLY IN A CONTRACTUAL RELATIONSHIP WITH NON-BANK FINANCIAL INSTITUTIONS I, the undersigned:
Full Name : ………………………………………………………………….
Identity Number : ………………………………………………………………….
Profession : ………………………………………………………………….
Hereby declare truthfully that I am not currently in a contractual relationship with any non-bank financial institution. This statement is made truthfully for use as appropriate. If this statement is found to be untrue at a later date, I am willing to be accountable for all consequences arising in accordance with applicable legislation. …………………, ………………………… Person making the statement, (Stamp Duty Rp 6,000,-) (……………………………………….) STTD Number:
Established in Jakarta on July 25, 2016
EXECUTIVE HEAD OF INSURANCE, PENSION FUND,
FINANCING INSTITUTION, AND
OTHER FINANCIAL SERVICE INSTITUTIONS SUPERVISOR FINANCIAL SERVICES AUTHORITY, signature FIRDAUS DJAELANI Copy matches the original Director of Law 1 Law Department signature Yuliana

ANNEX III
CIRCULAR LETTER OF THE FINANCIAL SERVICES AUTHORITY NUMBER 29 /SEOJK.05/2016 REGARDING THE FORM AND PROCEDURES FOR APPLICATIONS, REPORTING, AND CONTINUING EDUCATION PROGRAMS FOR ACTUARIES, PUBLIC ACCOUNTANTS, AND VALUERS ENGAGED IN THE NON-BANK FINANCIAL INDUSTRY

REACTIVATION OF REGISTERED CERTIFICATE FOR ACTUARIES, PUBLIC ACCOUNTANTS, AND VALUERS ENGAGED IN THE NON-BANK FINANCIAL INDUSTRY Format 1. Application Letter for Reactivation of Registered Certificate Format 2. List of Continuing Education Programs Attended in the Last 1 (One) Year for the Purpose of Application for Reactivation of Registered Certificate

Format 1: Application Letter for Reactivation of Registered Certificate …………………, …… …………………… ……… (Filled with place, date, month, and year) Number :
Attachments :
Subject : Application for Reactivation of Registered Certificate Actuarial Consultant/Public Accountant/Valuer *) To Honorable Financial Services Authority u. p. Director of Non-Bank Financial Industry Support Services Menara Merdeka Building, 20th Floor Jl. Budi Kemuliaan I No. 2 Jakarta – 10110 In accordance with the provisions of OJK Regulation Number 38/POJK.05/2016 concerning Registration and Supervision of Actuarial Consultants, Public Accountants, and Valuers Engaged in the Non-Bank Financial Industry, we hereby submit an application for reactivation of the Registered Certificate for Actuarial Consultant/Public Accountant/Valuer *) . In this regard, we enclose proof of attending continuing education programs attended for a maximum of 1 (one) year prior to the submission of this application for reactivation of the registered certificate. Thank you for your attention. Applicant, (……………………………………….) STTD Number:
*) Strike out what is not applicable
Supporting documents that must be submitted along with this letter ):
Proof of Attending Continuing Education Program ) filled in by the OJK side

Format 2: List of Continuing Education Programs Attended in 1 (One) Year Last for the Purpose of Application for Reactivation of Registered Certificate LIST OF CONTINUING EDUCATION PROGRAMS ATTENDED IN THE LAST 1 (ONE) YEAR FOR THE PURPOSE OF APPLICATION FOR REACTIVATION OF REGISTERED CERTIFICATE Full Name : …………………………………………………………………… Profession : Actuarial Consultant Public Accountant Valuer OJK Registered Certificate Number (STTD) :
……………………………………………………………………
No. PPL Title *)
PPL Activity
SKP
Date Place Organizer
*) by attaching a photocopy of the PPL certificate Established in Jakarta on July 25, 2016 EXECUTIVE HEAD OF INSURANCE, PENSION FUND, FINANCING INSTITUTION, AND OTHER FINANCIAL SERVICE INSTITUTIONS SUPERVISOR FINANCIAL SERVICES AUTHORITY, signature FIRDAUS DJAELANI Copy matches the original Director of Law 1 Law Department signature Yuliana

ANNEX IV
CIRCULAR LETTER OF THE FINANCIAL SERVICES AUTHORITY NUMBER 29 /SEOJK.05/2016 REGARDING THE FORM AND PROCEDURES FOR APPLICATIONS, REPORTING, AND ACTUARIES, PUBLIC ACCOUNTANTS, AND VALUERS ENGAGED IN THE NON-BANK FINANCIAL INDUSTRY

APPLICATION FOR RESIGNATION
ACTUARIES, PUBLIC ACCOUNTANTS, AND VALUERS
ENGAGED IN THE NON-BANK FINANCIAL INDUSTRY
Format 1. Application Letter for Resignation
Format 2. Resignation Form
Format 3. Stamped Statement Letter Stating That the Person Is Not Currently In a Contractual Relationship with LJKNB Format 4. Stamped Statement Letter Stating That the Actuarial Consultant/Public Accountant/Valuer Is Resigning and Has Completed All Obligations Arising from OJK

Format 1: Application Letter for Resignation
…………………, …… …………………… ………
(Filled with place, date, month, and year)
Number :
Attachments :
Subject : Application for Resignation of Actuarial Consultant/Public Accountant/Valuer *) To Honorable Financial Services Authority u. p. Director of Non-Bank Financial Industry Support Services Menara Merdeka Building, 20th Floor Jl. Budi Kemuliaan I No. 2 Jakarta – 10110 In accordance with the provisions of OJK Regulation Number 38/POJK.05/2016 concerning Registration and Supervision of Actuarial Consultants, Public Accountants, and Valuers Engaged in the Non-Bank Financial Industry, we hereby submit an application for resignation of Actuarial Consultant/Public Accountant/Valuer *) . In this regard, we enclose the completed resignation form along with other supporting documents. Thank you for your attention. Applicant, (……………………………………….) STTD Number:
*) Strike out what is not applicable

Format 2: Application Form for Resignation Upon Own Request FINANCIAL SERVICES AUTHORITY DIRECTORATE OF SUPPORT SERVICES FOR THE NON-BANK FINANCIAL INDUSTRY RESIGNATION FORM Profession applying:
Actuarial Consultant
Public Accountant
Appraiser
STATEMENT OF DATA AND INFORMATION TRUTH
I, the undersigned:
Full Name : ………………………………………………………………….
Identity Number : ………………………………………………………………….
Hereby declare that the data and information submitted in this resignation form are true.
This statement is made truthfully for use as appropriate. If this statement is found to be untrue at a later date, I am willing to be accountable for all consequences arising in accordance with applicable legislation. …………………, ………………………… Person making the statement, (Stamp Duty Rp 6,000,-) (……………………………………….) STTD Number:

I. APPLICANT INFORMATION
1. Full Name : ………………………………………………….
2. OJK STTD Number : ……………………………………………..
II. KKA/KAP/KJPP INFORMATION
1. Name of KKA/KAP/KJPP : ……………………………………………..
2. Business License of KKA/KAP/KJPP
KMK No. : ……………………………………………..
Date : ……… - …………………… - …………..
3. Position at KKA/KAP/KJPP : Leader
Partner Leader
Partner
Other
III. RESIGNATION INFORMATION
1. Reason for resignation:
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Applicant,
(………………………………………………)
STTD Number:
Supporting documents that must be submitted along with this form *) :
Stamped Statement Letter Stating That the Person Is Resigning and Has Completed All Obligations Arising from OJK Statement Letter Stating That the Actuarial Consultant, Public Accountant, or Valuer Is Not Currently in a Contractual Relationship with LJKNB Original Registered Certificate for Actuarial Consultant, Public Accountant, or Valuer *) filled in by the OJK side

Format 3: Stamped Statement Letter Stating That the Person Is Resigning and Has Completed All Obligations Arising from OJK STATEMENT LETTER RESIGNING AND HAS COMPLETED ALL OBLIGATIONS ARISING FROM OJK I, the undersigned:
Full Name : ………………………………………………………………….
Identity Number : ………………………………………………………………….
Profession : ………………………………………………………………….
Hereby declare truthfully that I am resigning as an Actuarial Consultant/Public Accountant/Valuer *) engaged in the Non-Bank Financial Industry and have completed all obligations arising from the Financial Services Authority. This statement is made truthfully for use as appropriate. If this statement is found to be untrue at a later date, I am willing to be accountable for all consequences arising in accordance with applicable legislation. …………………, ………………………… Person making the statement, (Stamp Duty Rp 6,000,-) (……………………………………….) STTD Number:
*) Strike out what is not applicable

Format 4: Statement Letter Stating That the Actuarial Consultant, Public Accountant, or Valuer Is Not Currently in a Contractual Relationship with LJKNB STATEMENT LETTER NOT CURRENTLY IN A CONTRACTUAL RELATIONSHIP WITH NON-BANK FINANCIAL INSTITUTIONS I, the undersigned:
Full Name : ………………………………………………………………….
Identity Number : ………………………………………………………………….
Occupation : ………………………………………………………………….
Hereby declare truthfully that I am not currently in a contractual relationship with any non-bank financial institution. This statement is made truthfully for use as appropriate. If this statement is found to be untrue at a later date, I am willing to be accountable for all consequences arising in accordance with applicable legislation. …………………, ………………………… Person making the statement, (Stamp Duty Rp 6,000,-) (……………………………………….) STTD Number:
Established in Jakarta on July 25, 2016
EXECUTIVE HEAD OF INSURANCE, PENSION FUND,
FINANCING INSTITUTION, AND
OTHER FINANCIAL SERVICE INSTITUTIONS SUPERVISOR FINANCIAL SERVICES AUTHORITY, signature FIRDAUS DJAELANI Copy matches the original Director of Law 1 Law Department signature Yuliana

ANNEX V
CIRCULAR LETTER OF THE FINANCIAL SERVICES AUTHORITY NUMBER 29 /SEOJK.05/2016 REGARDING THE FORM AND PROCEDURES FOR APPLICATIONS, REPORTING, AND ACTUARIES, PUBLIC ACCOUNTANTS, AND VALUERS ENGAGED IN THE NON-BANK FINANCIAL INDUSTRY

REPORTING BY ACTUARIES, PUBLIC ACCOUNTANTS, AND VALUERS ENGAGED IN THE NON-BANK FINANCIAL INDUSTRY Format 1. Report on Attending Continuing Education Programs Format 2. Report on Changes in Data and Information Format 3. Report on Violations of Applicable Legislation in the Financial Services Sector and/or at OJK, as well as Conditions or Estimated Conditions That May Endanger the Viability of LJKNB or Stakeholders

Format 1: Report on Attending Continuing Education Programs REPORT ON CONTINUING EDUCATION PROGRAM ACTIVITIES ACTUARIES, PUBLIC ACCOUNTANTS, AND VALUERS ENGAGED IN THE NON-BANK FINANCIAL INDUSTRY YEAR ……… Subject: Report on Continuing Education Program Activities Actuarial Consultant/Public Accountant/Valuer *) To Honorable Financial Services Authority u. p. Director of Non-Bank Financial Industry Support Services Menara Merdeka Building, 20th Floor Jl. Budi Kemuliaan I No. 2 Jakarta – 10110
Hereby we submit the report on continuing education program activities for Actuarial Consultant/Public Accountant/Valuer *) for the year .......
(filled with the relevant year) along with photocopies of the certificates of the aforementioned continuing education programs. This report is submitted to fulfill obligations as referred to in OJK Regulation Number 38/POJK.05/2015 concerning Registration and Supervision of Actuarial Consultants, Public Accountants, and Valuers Engaged in the Non-Bank Financial Industry. Thank you for your attention. …………., …… ………………… ……… Reporter, (……………………………………..….) STTD Number:
*) Strike out what is not applicable

REPORT ON CONTINUING EDUCATION PROGRAM ACTIVITIES ACTUARIES, PUBLIC ACCOUNTANTS, AND VALUERS ENGAGED IN THE NON-BANK FINANCIAL INDUSTRY YEAR ……… Full Name : …………………………………………………………………… Profession : Actuarial Consultant Public Accountant Valuer STTD Number : …………………………………………………………………… No. PPL Title *) PPL Activity SKP Date Place Organizer *) by attaching a photocopy of the PPL certificate or proof of PPL attendance …………., …… ………………… ……… Reporter, (……………………………………..….)

Format 2: Report on Changes in Data and Information REPORT ON CHANGES IN DATA AND INFORMATION ACTUARIES, PUBLIC ACCOUNTANTS, AND VALUERS ENGAGED IN THE NON-BANK FINANCIAL INDUSTRY Subject: Report on Changes in Data and Information Actuarial Consultant/Public Accountant/Valuer *) To Honorable Financial Services Authority u. p. Director of Non-Bank Financial Industry Support Services Menara Merdeka Building, 20th Floor Jl. Budi Kemuliaan I No. 2 Jakarta – 10110 In relation to the above, we hereby submit a report on changes in data and information for Actuarial Consultant/Public Accountant/Valuer *) in order to fulfill obligations as referred to in OJK Regulation Number 38/POJK.05/2015 concerning Registration and Supervision of Actuarial Consultants, Public Accountants, and Valuers Engaged in the Non-Bank Financial Industry. Thank you for your attention. …………., …… ………………… ……… Reporter, (……………………………………..….) STTD Number:
*) Strike out what is not applicable

REPORT ON CHANGES IN DATA AND INFORMATION
ACTUARIES, PUBLIC ACCOUNTANTS, AND VALUERS ENGAGED IN THE NON-BANK FINANCIAL INDUSTRY Full Name : …………………………………………………………………… Profession : Actuarial Consultant Public Accountant Public Accountant STTD Number : …………………………………………………………………… No. Data and Information Before Change After Change …………., …… ………………… ……… Reporter, (……………………………………..….)

Format 3: Report on Violations of Applicable Legislation in the Financial Services Sector and/or at OJK, as well as Conditions or Estimated Conditions That May Endanger the Viability of LJKNB or Stakeholders REPORT ON VIOLATIONS OF APPLICABLE LEGISLATION IN THE FINANCIAL SERVICES SECTOR AND/OR AT OJK, AS WELL AS CONDITIONS OR ESTIMATED CONDITIONS THAT MAY ENDANGER THE VIABILITY OF LJKNB OR STAKEHOLDERS …………………, …… …………………… ……… (Filled with place, date, month, and year) Number :
Attachments :
Subject : Report on Violations of Applicable Legislation in the Financial Services Sector and/or at OJK, as well as Conditions or Estimated Conditions That May Endanger the Viability of LJKNB or Stakeholders To Honorable Financial Services Authority u. p. Director of Non-Bank Financial Industry Support Services Menara Merdeka Building, 20th Floor Jl. Budi Kemuliaan I No. 2 Jakarta – 10110 Hereby we report that regarding ......... (filled with the name of LJKNB), on date .........., we have found matters that in our opinion must be reported to the Financial Services Authority in accordance with Article 10 of OJK Regulation Number 38/POJK.05/2015 concerning Registration and Supervision of Actuarial Consultants, Public Accountants, and Valuers Engaged in the Non-Bank Financial Industry, as follows:

1. ....................................................................................................................
2. ....................................................................................................................
   In this regard, we enclose evidence as supporting documentation for the aforementioned violations. Reporter, (……………………………………..….) STTD Number:
   Established in Jakarta on July 25, 2016
   EXECUTIVE HEAD OF INSURANCE, PENSION FUND,
   FINANCING INSTITUTION, AND
   OTHER FINANCIAL SERVICE INSTITUTIONS SUPERVISOR FINANCIAL SERVICES AUTHORITY, signature FIRDAUS DJAELANI Copy matches the original Director of Law 1 Law Department signature Yuliana