To:

Management of Employer Pension Funds; and
Acting Management of Financial Institution Pension Funds,
In their respective places.

COPY

CIRCULAR LETTER OF THE FINANCIAL SERVICES AUTHORITY REPUBLIC OF INDONESIA NUMBER 4 /SEOJK.05/2021

CONCERNING

FORM AND STRUCTURE OF PERIODIC REPORTS FOR PENSION FUNDS

In connection with the mandate of the provisions of Article 13 and Article 14 paragraph (3) of Financial Services Authority Regulation Number 5/POJK.05/2018 concerning Periodic Reports of Pension Funds (State Gazette of the Republic of Indonesia Year 2018 Number 45, Supplement to the State Gazette of the Republic of Indonesia Number 6195), it is necessary to regulate the provisions on the form, structure, and manner of submission of periodic reports of pension funds in this Financial Services Authority Circular Letter as follows:

I. GENERAL PROVISIONS

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

Pension Fund is a legal entity that manages and runs a program promising pension benefits.
Employer Pension Fund, hereinafter abbreviated as DPPK, is a Pension Fund established by a person or entity that employs employees, as the founder, to carry out a defined benefit pension program or a defined contribution pension program, for the benefit of some or all of its employees as participants, and which creates obligations for the employer.
Financial Institution Pension Fund, hereinafter abbreviated as DPLK, is a Pension Fund established by a bank or life insurance company to carry out a defined contribution pension program for individuals, both employees and self-employed workers, which is separate from the DPPK for employees of the respective bank or life insurance company.
Periodic Report is a report prepared by the Pension Fund for the benefit of the Financial Services Authority for a certain period.
Monthly Report is a report prepared by the Pension Fund for the benefit of the Financial Services Authority, which covers the period from January 1 to the end of the relevant month.
Annual Report is a report prepared by the Pension Fund for the benefit of the Financial Services Authority, which covers the period from January 1 to the end of the relevant year.
Other Reports are reports prepared by the Pension Fund for the benefit of the Financial Services Authority other than Monthly Reports and Annual Reports, which are submitted in a certain period.
Electronic Data is financial data referring to financial reports that have been audited by a public accountant and can be used for electronic data processing using a specific format.

II. FORM AND STRUCTURE OF PERIODIC REPORTS FOR PENSION FUNDS

Periodic Reports of Pension Funds are divided into types of reports as follows:
a. Monthly Report; b. Annual Report; and
c. Other Reports.
The Annual Report as referred to in item 1 letter b for Pension Funds consists of:
a. annual financial reports; and b. technical reports.
The annual financial report as referred to in item 2 letter a consists of:
a. annual financial reports that have been audited by a public accountant; and b. Electronic Data.
The annual financial report that has been audited by a public accountant as referred to in item 3 letter a follows the applicable financial accounting standards in Indonesia.
For DPPK, the form and structure of Periodic Reports as referred to in item 1 are as contained in Appendix I which is an integral part of this Financial Services Authority Circular Letter, with the following provisions:
a. the form and structure of Monthly Reports as referred to in item 1 letter a and Electronic Data as referred to in item 3 letter b, for DPPK implementing defined benefit pension programs, are as contained in Format IA; b. the form and structure of Monthly Reports as referred to in item 1 letter a and Electronic Data as referred to in item 3 letter b, for DPPK implementing defined contribution pension programs, are as contained in Format IB;
c. the form and structure of technical reports as referred to in item 2 letter b are as contained in Format IC; and
d. the form and structure of Other Reports as referred to in item 1 letter c are as contained in Format ID.
For DPLK, the form and structure of Periodic Reports as referred to in item 1 are as contained in Appendix II which is an integral part of this Financial Services Authority Circular Letter, with the following provisions:
a. the form and structure of Monthly Reports as referred to in item 1 letter a and Electronic Data as referred to in item 3 letter b are as contained in Format IIA; b. the form and structure of technical reports as referred to in item 2 letter b are as contained in Format IIB; and
c. the form and structure of Other Reports as referred to in item 1 letter c are as contained in Format IIC.

III. PROCEDURE FOR SUBMISSION OF PERIODIC REPORTS

Submission of Periodic Reports is done online (daring) through the Financial Services Authority's data communication network system.
In the event that the Financial Services Authority's data communication network system as referred to in item 1 is not yet available or experiences technical disturbances, the Pension Fund must submit Periodic Reports online (daring) via electronic mail to the Financial Services Authority.
In the event that the Pension Fund must submit Periodic Reports online (daring) via electronic mail to the Financial Services Authority as referred to in item 2, the Financial Services Authority provides the Pension Fund with the electronic mail address used for the submission of Periodic Reports.
In order to submit online (daring) via electronic mail as referred to in item 2, the Pension Fund must submit in writing to the Financial Services Authority the electronic mail address of the Pension Fund used for the submission of Periodic Reports to the Financial Services Authority.
In the event that the Financial Services Authority's data communication network system and electronic mail as referred to in items 1 and 2 experience technical disturbances, or the Pension Fund experiences disturbances so that it cannot submit Periodic Reports online (daring), Periodic Reports are submitted offline (luring) accompanied by written notification and supporting documents in the form of Periodic Reports either using media in the form of compact disk (CD) or other electronic data storage media, and sent to the Financial Services Authority via a letter signed by the management/acting management and addressed to:
Financial Services Authority u.p. Director of Pension Fund and Manpower Social Security Supervision Wisma Mulia 2 Building, 12th Floor Jalan Jenderal Gatot Subroto Kav. 40 Jakarta 12710.
Submission of Periodic Reports offline (luring) as referred to in item 5 is done in one of the following ways:
a. handed over directly to the Financial Services Authority office; or b. sent through a courier service company.
The Pension Fund is deemed to have submitted the Periodic Report with the following provisions:
a. for submission online (daring) via:

the Financial Services Authority's data communication network system, proven by a receipt from the Financial Services Authority's data communication network system; or
electronic mail to the Financial Services Authority, proven by proof of electronic mail delivery, in the event that delivery through the data communication network cannot be done; or
b. for submission offline (luring), proven by a receipt from the Financial Services Authority:

The Financial Services Authority may request original documents in the form of printed Periodic Reports that have been submitted by the Pension Fund through the Financial Services Authority's data communication network system.

IV. CLOSING PROVISIONS

At the time this Financial Services Authority Circular Letter takes effect, the Financial Services Authority Circular Letter Number 3/SEOJK.05/2019 concerning Form and Structure of Periodic Reports for Pension Funds is revoked and declared invalid.

This copy is in accordance with the original Legal Director 1 Legal Department signed Mufli Asmawidjaja

The provisions in this Financial Services Authority Circular Letter take effect on April 30, 2021.

Determined in Jakarta on January 21, 2021 EXECUTIVE HEAD OF SUPERVISOR INSURANCE, PENSION FUNDS, FINANCING INSTITUTIONS, AND OTHER FINANCIAL SERVICE INSTITUTIONS FINANCIAL SERVICES AUTHORITY REPUBLIC OF INDONESIA, signed RISWINANDI

APPENDIX I

CIRCULAR LETTER OF THE FINANCIAL SERVICES AUTHORITY REPUBLIC OF INDONESIA NUMBER 4 /SEOJK.05/2021

CONCERNING

FORM AND STRUCTURE OF PERIODIC REPORTS FOR PENSION FUNDS

FORMAT IA

To
The Director of Pension Fund and Manpower Social Security Supervision Financial Services Authority

MONTHLY REPORT / ELECTRONIC DATA
DEFINED BENEFIT PENSION PROGRAM
Per DD-MM-YYYY
EMPLOYER PENSION FUND

General Data
Reporting Date
Pension Fund Code
Pension Fund Name
Reporting Period
Reporting Month
Fiscal Year
Type of Reporting Period Annual Report/Monthly Report Management Name Management Position SID Number Audit Data Auditor License Number Audit Type Auditor Code Auditor Name Opinion Audit Executor Audit Date Report Preparer Officer Name Division Telephone Fax E-mail Management Person in Charge Person in Charge Name Position Telephone Fax E-mail Pension Fund Address

Description Code Percentage
Other Benefit Pension Program Combined ASSETS INVESTMENTS Bank Savings 1101 On-call Deposits at Banks 1102 Time Deposits at Banks 1103 Bank Deposit Certificates 1104 Securities issued by Bank Indonesia 1105 Government Securities 1106 Shares listed on the Indonesia Stock Exchange 1107 Corporate Bonds listed on the Indonesia Stock Exchange 1108 Corporate Sukuk listed on the Indonesia Stock Exchange 1109 Regional Bonds/Sukuk 1110 Mutual Funds 1111 MTN 1112 Asset-Backed Securities 1113 Real Estate Investment Fund in the form of collective investment contracts 1114 Infrastructure Investment Fund in the form of collective investment contracts 1115 Options contracts and forward contracts for securities listed on the Indonesia Stock Exchange 1116 REPO 1117 Direct Participation 1118 Land in Indonesia Buildings in Indonesia Land and Buildings in Indonesia TOTAL INVESTMENTS CURRENT ASSETS OUTSIDE INVESTMENTS Cash and Bank 1201 Contribution Receivables

Normal Contribution Employer
Normal Contribution Participant
Voluntary Contribution Participant
Additional Contribution
Interest Receivable on Late Contributions 1203 Prepaid Expenses 1204 Investment Receivables 1205 Investment Income Receivables 1206 Other Receivables 1207 TOTAL CURRENT ASSETS OUTSIDE INVESTMENTS OPERATIONAL ASSETS Land and Buildings 1301 Vehicles 1302 Computer Equipment 1303 Office Equipment 1304 Other Operational Assets 1305 TOTAL OPERATIONAL ASSETS OTHER ASSETS 1401 AVAILABLE ASSETS LIABILITIES Liabilities Outside Actuarial Present Value Due Pension and Other Benefits Payables 1501 Voluntary Benefits Payables 1502 Investment Payables 1503 Unearned Revenue 1504 Accrued Expenses 1505 Other Payables 1506 Total Liabilities Outside Actuarial Present Value TOTAL LIABILITIES NET ASSETS

DEFINED BENEFIT PENSION PROGRAM
NET ASSETS REPORT
Per DD-MM-YYYY

Other Benefit Pension Program Combined ADDITIONS Investment Income Interest/Profit Sharing Dividends Rent Gain (Loss) on Investment Disposal Other Investment Income Total Investment Income Increase (Decrease) in Investment Value 401 Due Contributions: 402

Normal Contribution Employer
Normal Contribution Participant
Voluntary Contribution Participant
Additional Contribution
Non-Investment Income 403
Transfer of Funds from Other Pension Funds 404 Total Additions DEDUCTIONS Investment Expenses 405 Operational Expenses 406 Non-Investment and Operational Expenses 407 Pension Benefits and Other Benefits Income Tax 408 Transfer of Funds to Other Pension Funds 409 Total Deductions INCREASE (DECREASE) IN NET ASSETS NET ASSETS AT BEGINNING OF PERIOD NET ASSETS AT END OF PERIOD

Description Code

DEFINED BENEFIT PENSION PROGRAM
NET ASSETS CHANGE REPORT
Accumulated to DD-MM-YYYY

Description Accumulated to DD-MM-YYYY

ASSETS
INVESTMENTS (Historical Value)
Bank Savings
On-call Deposits at Banks
Time Deposits at Banks
Bank Deposit Certificates
Securities issued by Bank Indonesia
Government Securities
Shares listed on the Indonesia Stock Exchange Corporate Bonds listed on the Indonesia Stock Exchange Corporate Sukuk listed on the Indonesia Stock Exchange Regional Bonds/Sukuk Mutual Funds MTN Asset-Backed Securities Real Estate Investment Fund in the form of collective investment contracts Infrastructure Investment Fund in the form of collective investment contracts Options contracts and forward contracts for securities listed on the Indonesia Stock Exchange REPO Direct Participation Land in Indonesia Buildings in Indonesia Land and Buildings in Indonesia Accumulated Depreciation of Buildings TOTAL INVESTMENTS DIFFERENCE IN INVESTMENT VALUATION CURRENT ASSETS OUTSIDE INVESTMENTS Cash and Bank Contribution Receivables

Normal Contribution Employer
Normal Contribution Participant
Voluntary Contribution Participant
Additional Contribution
Interest Receivable on Late Contributions Prepaid Expenses Investment Receivables Investment Income Receivables Other Receivables TOTAL CURRENT ASSETS OUTSIDE INVESTMENTS OPERATIONAL ASSETS Land and Buildings Vehicles Computer Equipment Office Equipment Other Operational Assets Accumulated Depreciation TOTAL OPERATIONAL ASSETS OTHER ASSETS TOTAL ASSETS LIABILITIES ACTUARIAL PRESENT VALUE DIFFERENCE IN ACTUARIAL PRESENT VALUE LIABILITIES OUTSIDE ACTUARIAL PRESENT VALUE Due Pension and Other Benefits Payables Voluntary Benefits Payables Investment Payables Unearned Revenue Accrued Expenses Other Payables TOTAL LIABILITIES OUTSIDE ACTUARIAL PRESENT VALUE TOTAL LIABILITIES

Description

DEFINED BENEFIT PENSION PROGRAM
BALANCE SHEET
Per DD-MM-YYYY

Other Benefit Pension Program Combined

Other Benefit Pension Program Combined INVESTMENT INCOME Interest/Profit Sharing Dividends Rent Gain (Loss) on Investment Disposal Other Investment Income Total Investment Income INVESTMENT EXPENSES Transaction Expenses Land and Building Maintenance Expenses Building Depreciation Expenses Investment Manager Expenses Custodian Expenses Other Investment Expenses Total Investment Expenses INVESTMENT BUSINESS RESULTS OPERATIONAL EXPENSES Employee, Management, and Supervisory Board Salaries/Honorariums. Office Expenses Maintenance Expenses Depreciation Expenses Third-Party Service Expenses Other Operational Expenses Total Operational Expenses OTHER INCOME AND EXPENSES Interest on Late Contributions Gain (Loss) on Sale of Operational Assets Gain (Loss) on Sale of Other Assets Other Non-Investment Income Non-Investment and Operational Expenses Total Other Income and Expenses INCOME BEFORE TAX INCOME TAX INCOME AFTER TAX

DEFINED BENEFIT PENSION PROGRAM
INCOME STATEMENT CALCULATION REPORT
Accumulated to DD-MM-YYYY

Description Accumulated to DD-MM-YYYY

Other Benefit Pension Program Combined

CASH FLOW FROM INVESTMENT ACTIVITIES
Receipt of Interest/Profit Sharing
Receipt of Dividends
Receipt of Rent
Other Investment Income
Investment Disposal
Investment Placement
Payment of Investment Expenses
Net Cash Flow from Investment Activities CASH FLOW FROM OPERATIONAL ACTIVITIES Payment of Operational Expenses Sale of Operational Assets Purchase of Operational Assets Sale of Other Assets Purchase of Other Assets Other Non-Investment Income Non-Investment and Operational Expenses Income Tax Net Cash Flow from Operational Activities CASH FLOW FROM FINANCING ACTIVITIES Receipt of Normal Contribution Employer Receipt of Normal Contribution Participant Receipt of Voluntary Contribution Participant Receipt of Additional Contribution Receipt of Interest on Late Contributions Receipt of Transfer of Funds from Other Pension Funds Payment of Transfer of Funds to Other Pension Funds Payment of Pension Benefits and Other Benefits Net Cash Flow from Financing Activities INCREASE (DECREASE) IN NET CASH CASH AT BEGINNING OF PERIOD CASH AT END OF PERIOD

Description

DEFINED BENEFIT PENSION PROGRAM
CASH FLOW STATEMENT
Accumulated to DD-MM-YYYY
Accumulated to DD-MM-YYYY

(4) Number of Partner Companies of Pension Fund Founders

Children
Deferred Pension
(3) Number of DPPK Participants (1) + (2)
Widows/Widowers
Children
Deferred Pension
b. Partner Founders
Retirees
Widows/Widowers
Total
PENSION FUND PARTICIPATION
Per DD-MM-YYYY
Retirees
Description Other Benefit Pension Program (1) Active Participants a. Founder b. Partner Founder (2) Inactive Participants a. Founder

Value
Net Asset Value based on audited financial reports* a. b.
c. etc.
a. Participant Contributions b. Employer Contributions
c. Additional Contributions
3 Other Receivables a. b.
c. etc.
4 Other Assets a. b.
c. etc.
*: audited financial reports only for annual Funding Value Total Funding Value Per DD-MM-YYYY Description Deductions Assets in court dispute, or controlled or seized by competent authorities Total Contributions, which on the actuarial valuation date have not been paid for more than 3 (three) months since the due date Total Deductions Actuarial interest rate .....% Actuarial interest rate

Bank Savings
On-call Deposits at Banks
Time Deposits at Banks
Bank Deposit Certificates
Securities issued by Bank Indonesia
Government Securities
Shares listed on the Indonesia Stock Exchange Corporate Bonds listed on the Indonesia Stock Exchange Corporate Sukuk listed on the Indonesia Stock Exchange Regional Bonds/Sukuk Mutual Funds MTN Asset-backed securities Real Estate Investment Fund in the form of collective investment contracts Infrastructure Investment Fund in the form of collective investment contracts Options contracts and forward contracts for securities listed on the Indonesia Stock Exchange REPO Direct Participation Land in Indonesia Buildings in Indonesia Land and Buildings in Indonesia TOTAL INVESTMENTS Feb Mar Apr Nov Dec DEFINED BENEFIT PENSION PROGRAM Sep Oct INVESTMENT RECAP Per DD-MM-YYYY May Jun Jul Aug Description Jan

Interest/Profit Sharing Dividends Rent Gain/Loss Disposal Others Bank Savings On-call Deposits at Banks Time Deposits at Banks Bank Deposit Certificates Securities issued by Bank Indonesia Government Securities Shares listed on the Indonesia Stock Exchange Corporate Bonds listed on the Indonesia Stock Exchange Corporate Sukuk listed on the Indonesia Stock Exchange Regional Bonds/Sukuk Mutual Funds MTN Asset-backed securities Real Estate Investment Fund in the form of collective investment contracts Infrastructure Investment Fund in the form of collective investment contracts Options contracts and forward contracts for securities listed on the Indonesia Stock Exchange REPO Direct Participation Land in Indonesia Buildings in Indonesia Land and Buildings in Indonesia Total Note:
the Unrealized Investment Results column uses data according to the Increase/Decrease in Investment Value account on the LPAN sheet

DEFINED BENEFIT PENSION PROGRAM
INVESTMENT RESULTS REPORT
Per DD-MM-YYYY
Investment Type Realized Investment Results Average Investment Net Investment Results Investment Expenses Unrealized Investment Results

DEFINED BENEFIT PENSION PROGRAM
OTHER BENEFITS INVESTMENT RESULTS REPORT Per DD-MM-YYYY Investment Type Realized Investment Results Unrealized Investment Results Investment Expenses Net Investment Results Average Investment ROI

Rupiah Non-Rupiah Total Rupiah Non-Rupiah Total Rupiah Non-Rupiah Total Rupiah Non-Rupiah Total Rupiah Non-Rupiah Total A. Investment Assets Bank Savings On-call Deposits at Banks Time Deposits at Banks Bank Deposit Certificates Securities issued by Bank Indonesia Government Securities Shares listed on the Indonesia Stock Exchange Corporate Bonds listed on the Indonesia Stock Exchange Corporate Sukuk listed on the Indonesia Stock Exchange Regional Bonds/Sukuk Mutual Funds MTN Asset-backed securities Real Estate Investment Fund in the form of collective investment contracts Infrastructure Investment Fund in the form of collective investment contracts Options contracts and forward contracts for securities listed on the Indonesia Stock Exchange REPO Direct Participation Land in Indonesia Buildings in Indonesia Land and Buildings in Indonesia Total Investments B. Current Assets Outside Investments Cash and Bank Contribution Receivables Normal Contribution Employer Normal Contribution Participant Voluntary Contribution Participant Additional Contribution Interest Receivable on Late Contributions Prepaid Expenses Investment Receivables Investment Income Receivables Other Receivables Total Current Assets Outside Investments
C. Operational Assets
Land and Buildings
Vehicles
Computer Equipment
Office Equipment
Other Operational Assets
Total Operational Assets
D. Other Assets
E. Total Assets (A+B+C+D)
F. Actuarial Present Value
G. Liabilities Outside Actuarial Present Value Due Pension and Other Benefits Payables Voluntary Benefits Payables Investment Payables Unearned Revenue Accrued Expenses Other Payables Total Liabilities Outside Actuarial Present Value H. Total Liabilities (F+G)
I. Difference between Total Assets and Total Liabilities (E-H)
J. Funding Adequacy Ratio (%) Total

DEFINED BENEFIT PENSION PROGRAM
ASSET AND LIABILITY RECAPITULATION
Per DD-MM-YYYY
(in rupiah)
Due >= 10 Years Description Due < 1 year 1 year <= Due < 5 years 5 year <= Due < 10 years

Type Amount Percentage Against Total Investments a b c d e f g ... Details of Investments on One Party Investment No. Counterparty Name Limit in Instructions Investment Investment Limit According to Regulations Per DD-MM-YYYY

Type Amount Percentage Against Total Investments a b c d e f g ... Details of Investments on Affiliated Parties Per DD-MM-YYYY No. Counterparty Name Investment Affiliation Relationship Description

Type Amount Percentage Against Total Investments a b c d e f g ... Note:
a. Shares with issuers suspected of bankruptcy b. Mutual Funds suspected of being traded abnormally Investments identified as problematic can be obtained from investment balances on parties identified as problematic from the Pension Fund Financial Reports. Information on investees experiencing problems (default risk) can be obtained, among others, from investee financial reports, media disclosures, and/or from rating agencies. Examples of conditions or parties identified as problematic are:
c. Bond issuers or bank deposit issuers recording losses.
d. There is a downgrade of bond instrument ratings below investment grade. e. There is a delay in coupon payments for Bonds or interest on Deposits. f. Bond issuers or deposit issuers involved in legal cases or suspected of fraud. g. Restructured bonds h. Ownership of Land and/or Buildings not yet in the name of the Pension Fund Details of Investments Identified as Problematic Per DD-MM-YYYY No. Counterparty Name Investment Category Problematic Description

Name of Investment Type
Balance
Name of Investment Type
Security Series Ownership Type Rating Balance Name of Investment Type Investment Manager Fair Value % of Government Bonds in Mutual Funds Balance Name of Investment Type Investment Manager Issuer Receiving Funds/Project Balance Name of Investment Type Security Series Ownership Type Rating Balance Name of Investment Type Balance ….. Total DETAILS OF COMPLIANCE WITH REGULATIONS ON GOVERNMENT BOND INVESTMENTS GOVERNMENT BONDS CORPORATE BONDS / SUKUK INFRASTRUCTURE MUTUAL FUNDS UNDERLYING GOVERNMENT BONDS MUTUAL FUNDS LIMITED PARTICIPATION ASSET-BACKED SECURITIES OTHER INVESTMENTS FOR INFRASTRUCTURE PROJECT FINANCING GOVERNMENT No.

Investment Income Ratio (ROI)
A. Total Investment Income – Investment Expenses B. Average Investments
C. Ratio (A:B)
Investment Income to Assets Ratio (ROA) A. (Total Investment Income + Non-Investment Income) - (Investment Expenses + Operating Expenses + Non-Investment and Operating Expenses) B. Average Available Assets
C. Ratio (A:B)
Operating Expense Ratio (BOPO)
A. Operating Expenses
B. Investment Income + Non-Investment Income
C. Ratio (A:B)
Fund Sufficiency Ratio (RKD)
A. Funding Wealth (KUP) x 100%
B. Actuarial Present Value (NKA)
C. Ratio (A:B)
Contribution Receivable Age Ratio (RUPI) A. Contribution Receivables (LAN) x Number of Months Elapsed B. Due Contributions (LPAN)
C. Ratio (A:B)
Investment to Net Assets Ratio (RITA)
A. Total Investments x 100%
B. Total Net Assets
C. Ratio (A:B)
Investment Receivables and Investment Income Receivables to Total Investments A. Investment Receivables + Investment Income Receivables B. Total Investments
C. Ratio (A:B)
Investment Growth Ratio
A. (Total Investments t1 - Total Investments t0) x 100% B. Total Investments t0
C. Ratio (A:B)
Market price changes of Pension Fund assets A. (SPIn-SPIn-1) x 100% B. SPIn-1
C. Ratio (A:B)
SPI compared to total income
A. SPI
B. Total Income
C. Ratio (A:B)
SPI compared to net assets
A. SPI
B. Net Assets
C. Ratio (A:B)
Minimum Liquidity Ratio / Cash Ratio
A. Current Assets or Investments for Minimum Liquidity Fulfillment B. Operating Costs + Investment Costs + Pension Benefits and Other Benefits Due within One Year
C. Ratio (A:B)
Cash Inflows compared to Cash Outflows A. Cash Inflows from Investment, Operating, and Financing Activities B. Cash Outflows from Investment, Operating, and Financing Activities
C. Ratio (A:B)
Contribution Receivable to Net Assets Ratio A. Contribution Receivables B. Net Assets
C. Ratio (A:B)
Growth Ratio of Founder's Contribution Receivables (Employer Contributions + Additional Contributions) A. (Total Founder's Contribution Receivables t1 - Total Founder's Contribution Receivables t0) X 100% B. Total Founder's Contribution Receivables t0
C. Ratio (A:B)
Ratio of Total Long-Term Assets to Total Long-Term Liabilities A. Total Long-Term Assets x 100% B. Total Long-Term Liabilities
C. Ratio (A:B)
Income to Expenditure Ratio
A. Operating Expenses + Investment Expenses + Pension Benefit Payments B. Total Income
C. Ratio (A:B)
Interest rate spread
A. Investment Income Ratio (ROI)
B. Actuarial Interest Rate
C. Ratio (A-B)
Current Assets to Total Assets Ratio
A. Current Assets
B. Total Assets
C. Ratio (A:B)
Current Liabilities to Total Liabilities Ratio A. Current Liabilities B. Total Liabilities
C. Ratio (A:B)
Operating Expense Ratio
A. Operating Expenses + Investment Expenses B. Investment Income
C. Ratio (A:B)

Current assets are assets with a maturity of less than 1 year (excluding operational assets and other assets) as presented in the Pension Fund Financial Statements.
Total assets are available assets as presented in the Pension Fund Financial Statements.
Current liabilities are liabilities with a maturity of less than 1 year as presented in the Pension Fund Financial Statements.
Total Liabilities are the Actuarial Present Value for PPMP and Pension Benefit Liabilities for PPIP.
Cash flows from investment activities are all investment activities except for the placement and release of investments as presented in the financial statements.
Cash flows from operating activities are all operating activities except for the placement and release of operational assets and other assets as presented in the financial statements.
Cash flows from financing activities are as presented in the financial statements.
Operating expenses are as presented in the Statement of Changes in Net Assets.
Investment expenses are as presented in the Statement of Changes in Net Assets.
Investment income includes realized and unrealized investment income as presented in the Statement of Changes in Net Assets.
SPI is the Investment Valuation Difference for instruments exposed to market risk that are actively traded. Examples: investments in the capital market and foreign currency-denominated deposits.
Total Income is total realized and unrealized income in the statement of changes in net assets.
SPI is the Investment Valuation Difference for instruments exposed to market risk that are actively traded.
Example: investments in the capital market and foreign currency-denominated deposits.
The comparison between long-term assets and long-term liabilities is obtained from the Pension Fund Financial Statements.
Assets with a life > 1 year according to information as stated in the Pension Fund Financial Statements.
Liabilities with a life > 1 year according to information as stated in the Pension Fund Financial Statements.
Total
Total Investment Income is as presented in the Statement of Changes in Net Assets.
Investment Expenses are as presented in the Statement of Changes in Net Assets.
For the calculation of average investments, the average investment assets throughout the year are used.
Total Investment Income is income that has been realized and unrealized. Total Investment Income is as presented in the Statement of Changes in Net Assets.
Non-Investment Income is as presented in the Statement of Changes in Net Assets.
Investments are as presented in the Net Assets Statement.
For the calculation of Operating Expenses, it is as presented in the Statement of Changes in Net Assets.
For the calculation of total available assets, the average assets throughout the year are used. Total Available Assets are as presented in the Net Assets Statement.
Operating expenses as stated in the statement of changes in net assets.
Investment Income is realized income as stated in the statement of changes in net assets.
Non-Investment Income as stated in the statement of changes in net assets.
FINANCIAL RATIOS
Per DD-MM-YYYY
Description Pension Program Other Benefits Remarks

No. Investment Manager Name Contract Number Contract Date Contract Period Investment Type Total Fair Value of Funds Managed (Rp) Acquisition Value (Managed by Investment Manager) Investment Valuation Difference Return (%) Net Investment Yield (Rp) Total Management Fees Charged (Rp) Affiliated with Pension Fund (Yes/No) 1. 2.
3. etc
1.
2.
3. etc
1.
2.
3. etc
: if using Investment Manager services Format for Fund Management Contract (KPD) by Investment Manager Pension Fund ….. Use of Investment Manager Per DD-MM-YYYY Total etc.

Self-Managed/ KPD
Investment Manager Name a b c d e f g h i j k … Total Bank Code DETAILS OF SAVINGS No. Bank Name Date of Acquisition Nominal Value Interest Rate/Nisbah Pension Program/ Other Benefits Remarks Branch Management

Self-Managed/ KPD
Investment Manager Name a b c d e f g h i j k l … Total Bank Code DETAILS OF ON-CALL DEPOSITS No. Bank Name Date of Acquisition Nominal Value Tenor Interest Rate/Nisbah Pension Program/ Other Benefits Remarks Branch Management

Self-Managed/ KPD
Investment Manager Name a b c d e f g h i j k l … Total Bank Code DETAILS OF TIME DEPOSITS No. Bank Name Date of Acquisition Nominal Value Tenor Interest Rate/Nisbah Pension Program/ Other Benefits Remarks Branch Management

a b c d e f g h i j k l m n o p
…
Total
Management
Self-Managed/ KPD
Investment Manager Name
DETAILS OF FOREIGN CURRENCY TIME DEPOSITS Nominal Value Fair Value % Investment Valuation Difference Remarks No. Bank Name Branch Bank Code Date of Acquisition Fair Value Currency Type Tenor Interest Rate/Nisbah Pension Program/ Other Benefits

Self-Managed/ KPD Investment Manager Name a b c d e f g h i j k l … Total Bank Code DETAILS OF CERTIFICATES OF DEPOSIT No. Bank Name Date of Acquisition Nominal Value Tenor Interest Rate/Nisbah Pension Program/ Other Benefits Remarks Branch Management

Fair Value %
Self-Managed/ KPD
Investment Manager Name a b c d e f g h i j k l m n … Total Pension Program/ Other Benefits Remarks Management DETAILS OF INDONESIA BANK CERTIFICATES No. Security Code Date of Acquisition Nominal Value Coupon (%) Maturity Date Acquisition Value Fair Value Investment Valuation Difference

Fair Value %
Self-Managed/ KPD
Investment Manager Name a b c d e f g h i j k l m n o … Total Pension Program/ Other Benefits Recording Method Remarks Management DETAILS OF GOVERNMENT SECURITIES No. Security Code Date of Acquisition Nominal Value Coupon (%) Maturity Date Acquisition Value Fair Value Investment Valuation Difference

Fair Value %
Self-Managed/ KPD
Investment Manager Name a b c d e f g h i j k l m n … Total Pension Program/ Other Benefits Remarks Management DETAILS OF SHARES No. Share Code Issuer Name Date of Acquisition Number of Shares Acquisition Value Market Value Investment Valuation Difference Economic Sector

Beginning End Fair Value % Self-Managed/ KPD Investment Manager Name a b c d e f g h i j k l m n o p q r s t … Total Fair Value Investment Valuation Difference Economic Sector Pension Program/ Other Benefits Recording Method DETAILS OF CORPORATE BONDS No. Issuer Name Bond Code Bond Name Date of Acquisition Nominal Value Coupon (%) Maturity Date Rating Remarks Management Acquisition Value

Economic Sector
Beginning End Fair Value % Self-Managed/ KPD Investment Manager Name a b c d e f g h i j k l m n o p q r s t … Total Management DETAILS OF SUKUK No. Issuer Name Sukuk Code Sukuk Name Date of Acquisition Nominal Value Coupon (%) Maturity Date Rating Acquisition Value Fair Value Investment Valuation Difference Pension Program/ Other Benefits Recording Method Remarks

Beginning End Fair Value % Self-Managed/ KPD Investment Manager Name a b c d e f g h i j k l m n o p q r s t … Total Fair Value Investment Valuation Difference Economic Sector Pension Program/ Other Benefits Recording Method DETAILS OF REGIONAL BONDS/SUKUK No. Issuer Name Regional Bond/Sukuk Code Regional Bond/Sukuk Name Date of Acquisition Nominal Value Coupon (%) Maturity Date Rating Remarks Management Acquisition Value

Fair Value %
Self-Managed/ KPD
Investment Manager Name a b c d e f g h i j k l m n o … Total *) letter d:
Filled with Mutual Fund Type is Money Market Mutual Fund/Fixed Income Mutual Fund/Mixed Mutual Fund/Equity Mutual Fund/Protected Mutual Fund/Mutual Fund with Guarantee/Index Mutual Fund/Contractual Collective Investment Vehicle Limited Participation Mutual Fund/Mutual Fund whose Shares/Participation Units are Traded on the Stock Exchange Management DETAILS OF MUTUAL FUNDS No. Code Product Name Mutual Fund Type *) Investment Manager Date of Acquisition Number of Units Acquisition Value Fair Value Investment Valuation Difference Pension Program/ Other Benefits Remarks

Beginning End Fair Value % Self-Managed/ KPD Investment Manager Name a b c d e f g h i j k l m n o p q r s … Total Management Economic Sector DETAILS OF MTN No. Code Product Name Issuer Name Date of Acquisition Nominal Value Coupon (%) Maturity Date Rating Acquisition Value Fair Value Investment Valuation Difference Pension Program/ Other Benefits Remarks

Beginning End Fair Value % Self-Managed/ KPD Investment Manager Name a b c d e f g h i j k l m n o p q r s … Total Management Economic Sector DETAILS OF ASSET-BACKED SECURITIES No. Code Product Name Issuer Name Date of Acquisition Nominal Value Coupon (%) Maturity Date Rating Acquisition Value Fair Value Investment Valuation Difference Pension Program/ Other Benefits Remarks

Fair Value % Self-Managed/ KPD
Investment Manager Name a b c d e f g h i j k l m n … Total Pension Program/ Other Benefits Remarks Management DETAILS OF REAL ESTATE INVESTMENT FUNDS IN THE FORM OF COLLECTIVE INVESTMENT CONTRACTS No. Code Product Name Investment Manager Date of Acquisition Number of Units Acquisition Value Fair Value Investment Valuation Difference

Fair Value % Self-Managed/ KPD
Investment Manager Name a b c d e f g h i j k l m n … Total Pension Program/ Other Benefits Remarks Management DETAILS OF INFRASTRUCTURE INVESTMENT FUNDS IN THE FORM OF COLLECTIVE INVESTMENT CONTRACTS No. Code Product Name Investment Manager Date of Acquisition Number of Units Acquisition Value Net Asset Value Investment Valuation Difference

Fair Value % Self-Managed/ KPD Investment Manager Name a b c d e f g h i j k l m … Total Remarks Management DETAILS OF OPTIONS CONTRACTS AND FUTURES CONTRACTS FOR SECURITIES LISTED ON THE INDONESIA STOCK EXCHANGE No. Issuer Name Buyer Name Date of Acquisition Tenor Acquisition Value Fair Value Investment Valuation Difference Pension Program/ Other Benefits

Beginning End Nominal % Fair Value %
Self-Managed/ KPD
Investment Manager Name a b c d e f g h i j k l m n o p q r s t … Total Management DETAILS OF REPO No. Counterparty Collateral Type (Government Bonds/Bills/Corporate Bonds) Date of Acquisition Collateral Value Rating Tenor Category (KSEI/BIS4) Acquisition Value Margin Amortized Cost Sale Value Investment Valuation Difference Pension Program/ Other Benefits Remarks

Job Title Date % Ownership Total % Ownership Total Date % Ownership Total Value % a b c d e f g h i j k l m n o p q r … Total Self-Managed/ KPD Investment Manager Name Pension Fund Founder Founder Partner Board of Directors Recipient of Delegation Labor Union whose Members are DP Participants Other Founders Founder Partner Board of Directors Recipient of Delegation Labor Union whose Members are DP Participants Other s t u v w x y z a1 b1 c1 d1 e1 f1 g1 h1 i1 j1 k1 … Total ) letter e :
Filled with Domestic LJK/Non-Domestic LJK/Foreign LJK/Non-Foreign LJK No. Management Remarks No. Company Name (1) Pension Fund Representative Total Paid-Up Capital Ownership Percentage (v) Subsidiaries from Direct Participation (2) Total Paid-Up Capital Subsidiaries from Direct Participation Ownership Percentage (e1) Appraisal/Fair Value Investment Valuation Difference Economic Sector Pension Program/ Other Benefits DETAILS OF DIRECT PARTICIPATION Participation Category) Date of Acquisition Initial Placement Acquisition Value As of report date

Object Type
(Land/Building/Land&Building) Fair Value % Self-Managed/ KPD Investment Manager Name a b c d e f g h i j k l m n o p q r s t u … Total Management Book Value Appraisal Value/ Fair Value Appraisal Year Public/Independent Appraiser Name KJPP Name Investment Valuation Difference DETAILS OF LAND, BUILDINGS, OR LAND AND BUILDINGS IN INDONESIA No. Address Location (City, Province) Area Type of Proof of Ownership Ownership Document Number Date of Acquisition Acquisition Value Accumulated Depreciation Pension Program/ Other Benefits Remarks

No. Cash/Bank Name Branch Bank Code Account Number Nominal Pension Program/ Other Benefits Remarks (Purpose of use) a b c d e f g h … Total DETAILS OF CASH AND BANKS

Age of Receivable <=3
Months
Age of Receivable >3
Months
Total
Age of Receivable <=3
Months
Age of Receivable >3
Months
Total
Age of Receivable <=3
Months
Age of Receivable >3
Months
Total a b c d e f g h i j k l m n
…
Total
DETAILS OF CONTRIBUTION RECEIVABLES
No. Employer Name
(Founder/Founder Partner)
Employer Contribution Receivables Participant Contribution Receivables Additional Contribution Receivables Voluntary Participant Contribution Receivables Pension Program/ Other Benefits Remarks

a b c d e f g
…
Total
DETAILS OF LATE CONTRIBUTION INTEREST RECEIVABLES No.
Employer Name
(Founder/Founder Partner)
Participant Contribution Interest Receivables Employer Contribution Interest Receivables Additional Contribution Interest Receivables Pension Program/ Other Benefits Remarks

No. Expense Type Amount Pension Program/ Other Benefits Remarks a b c d e … Total DETAILS OF PREPAID EXPENSES

No. Investment Receivable Type Counterparty Nominal Pension Program/ Other Benefits Remarks a b c d e f … Total DETAILS OF INVESTMENT RECEIVABLES

No.
Investment Income Receivable Type
Counterparty Nominal
Pension Program/
Other Benefits Remarks a b c d e f
…
Total
DETAILS OF INVESTMENT INCOME RECEIVABLES

No. Other Receivable Type Counterparty Nominal Pension Program/ Other Benefits Remarks a b c d e f … Total DETAILS OF OTHER RECEIVABLES

No.
Object Type
(Land/Building/Land&
Building)
Certificate Number Address Location Date of Acquisition Acquisition Value Accumulated Depreciation Book Value Acquisition Value on Report Date Remarks a b c d e f g h i j … Total DETAILS OF LAND AND BUILDINGS

No. Vehicle Plate Number Vehicle Type Date of Acquisition Acquisition Value Accumulated Depreciation Book Value Remarks a b c d e f g h … Total DETAILS OF VEHICLES

No.
Computer Equipment Type
Date of Acquisition Acquisition Value
Accumulated
Depreciation
Book Value Remarks a b c d e f g
…
Total
DETAILS OF COMPUTER EQUIPMENT

No.
Office Equipment Type
Date of
Acquisition
Acquisition Value
Accumulated
Depreciation
Book Value Remarks a b c d e f g
…
Total
DETAILS OF OFFICE EQUIPMENT

No.
Other Operational Asset Type
Date of Acquisition Acquisition Value
Accumulated
Depreciation
Book Value Remarks a b c d e f g
…
Total
DETAILS OF OTHER OPERATIONAL ASSETS

No. Other Asset Type Date of Acquisition Asset Value Remarks a b c d e … Total Other Assets Detail

<= 1 year >1 year Total a b c d e f
…
Total
DETAILS OF DUE PENSION BENEFIT LIABILITIES No.
Amount Pension Program/
Other Benefits Remarks

<= 1 year >1 year Total a b c d e
…
Total
No.
Amount
DETAILS OF DUE VOLUNTARY PENSION BENEFIT LIABILITIES Remarks

No. Investment Type Counterparty Value Pension Program/ Other Benefits Remarks a b c d e f … Total DETAILS OF INVESTMENT LIABILITIES

No.
Advance Income Detail
Counterparty Value
Pension Program/
Other Benefits Remarks a b c d e f
…
Total
DETAILS OF ADVANCE INCOME RECEIVED

No.
Accrued Expense Detail
Counterparty Value
Pension Program/
Other Benefits Remarks a b c d e f
…
Total
DETAILS OF ACCRUED EXPENSES

No. Other Liability Type Counterparty Value Pension Program/ Other Benefits Remarks a b c d e f … Total DETAILS OF OTHER LIABILITIES

No. Investment Type
Investment Valuation Difference
Increase/
Decrease
Pension Program/
Other Benefits Remarks a b c d e f
...
Total
Detail of Investment Increase/Decrease

% Amount % Amount a b c d e f g h i j k l m n o p q r ... Total Pension Program/ Other Benefits Remarks Normal Participant Contributions Normal Employer Contributions Voluntary Participant Contributions Additional Contributions Normal Participant Contributions Normal Employer Contributions Additional Contributions Voluntary Participant Contributions Detail of Due Contributions No. Founder Name/ Founder Partner PhDP Due Contributions Contribution Receipts Underpayment/Overpayment Normal Participant Contributions Normal Employer Contributions Additional Contributions

No.
Non-Investment Income Type
Amount
Pension Program/
Other Benefits Remarks a b c d e
...
Total
Detail of Non-Investment Income

No.
Name of Pension Fund transferring
Amount
Pension Program/
Other Benefits
Detail of Other Benefits *)
Remarks a b c d e f
...
Total
*) letter e:
Detail of Transfers from Other Pension Funds Filled with Education Fund/Housing Fund/Religious Worship Fund/Disability Benefit/Death Benefit/Health Benefit/Severance Fund/Additional Benefit Fund

No. Expense Type Amount
Pension Program/
Other Benefits Remarks a b c d e
...
Total
Detail of Investment Expenses

No. Expense Type Amount
Pension Program/
Other Benefits Remarks a b c d e
...
Total
Detail of Operating Expenses

No. Expense Type Amount
Pension Program/
Other Benefits Remarks a b c d e
...
Total
Detail of Non-Investment and Operating Expenses

No.
Income Tax Type
Amount
Pension Program/
Other Benefits Remarks a b c d e
…
Total
Detail of Income Tax

No.
Pension Fund receiving Transfer
Amount
Pension Program/
Other Benefits
Detail of Other Benefits *) Remarks a b c d e f ...
Total
*) letter e:
Detail of Transfers to Other Pension Funds Filled with Education Fund/Housing Fund/Religious Worship Fund/Disability Benefit/Death Benefit/Health Benefit/Severance Fund/Additional Benefit Fund

FORMAT I B
To
Director of Pension Fund and BPJS Ketenagakerjaan Supervision Financial Services Authority MONTHLY REPORT / ELECTRONIC DATA DEFINED CONTRIBUTION PENSION PROGRAM PER DD-MM-YYYY EMPLOYER PENSION FUND

General Data
Reporting Date
Pension Fund Code
Pension Fund Name
Reporting Period
Reporting Month
Fiscal Year
Reporting Period Type Annual Report/Monthly Report Board Member Name Board Member Position SID Number Audit Data Auditor License Decree Audit Type Auditor Code Auditor Name Opinion Audit Executor Audit Date Report Preparer Officer Name Division Telephone Fax E-mail Responsible Board Member Responsible Person Name Position Telephone Fax E-mail Pension Fund Address

Description Detail Code Percentage
Investment Pension Program Other Benefits Combined ASSETS INVESTMENTS Bank Savings 1101 Bank On-Call Deposits 1102 Bank Time Deposits 1103 Bank Certificates of Deposit 1104 Securities issued by Bank Indonesia 1105 Government Bonds 1106 Shares listed on the Indonesia Stock Exchange 1107 Corporate Bonds listed on the Indonesia Stock Exchange 1108 Corporate Sukuk listed on the Indonesia Stock Exchange 1109 Regional Bonds/Sukuk 1110 Mutual Funds 1111 MTN 1112 Asset-Backed Securities 1113 Real Estate Investment Funds in the form of collective investment contracts 1114 Infrastructure Investment Funds in the form of collective investment contracts 1115 Options contracts and futures contracts for securities listed on the Indonesia Stock Exchange 1116 REPO 1117 Direct Participation 1118 Land in Indonesia Buildings in Indonesia Land and Buildings in Indonesia TOTAL INVESTMENTS CURRENT ASSETS OTHER THAN INVESTMENTS Cash and Banks 1201 Contribution Receivables 1202

Employer Normal Contributions
Participant Normal Contributions
Participant Voluntary Contributions
Late Contribution Interest Receivables 1203 Prepaid Expenses 1204 Investment Receivables 1205 Investment Income Receivables 1206 Other Receivables 1207 TOTAL CURRENT ASSETS OTHER THAN INVESTMENTS OPERATIONAL ASSETS Land and Buildings 1301 Vehicles 1302 Computer Equipment 1303 Office Equipment 1304 Other Operational Assets 1305 TOTAL OPERATIONAL ASSETS OTHER ASSETS 1401 AVAILABLE ASSETS LIABILITIES Liabilities other than Pension Benefit Liabilities Due Pension Benefits and Other Benefits 1501 Voluntary Benefit Liabilities 1502 Investment Liabilities 1503 Advance Income Received 1504 Accrued Expenses 1505 Other Liabilities 1506 Total Liabilities other than Pension Benefit Liabilities TOTAL LIABILITIES NET ASSETS DEFINED CONTRIBUTION PENSION PROGRAM NET ASSETS STATEMENT Per DD-MM-YYYY

Pension Program Other Benefits Combined ADDITIONS Investment Income Interest/Profit Sharing Dividends Rent Profit (Loss) on Investment Disposal Other Investment Income Total Investment Income Increase (Decrease) in Investment Value 401 Due Contributions: 402

Employer Normal Contributions
Participant Normal Contributions
Participant Voluntary Contributions
Non-Investment Income 403
Transfer of Funds from Other Pension Funds 404 Total Additions DEDUCTIONS Investment Expenses 405 Operating Expenses 406 Non-Investment and Operating Expenses 407 Pension Benefits and Other Benefits Income Tax 408 Transfer of Funds to Other Pension Funds 409 Total Deductions INCREASE (DECREASE) IN NET ASSETS NET ASSETS AT BEGINNING OF PERIOD NET ASSETS AT END OF PERIOD Detail Code DEFINED CONTRIBUTION PENSION PROGRAM STATEMENT OF CHANGES IN NET ASSETS Accumulated to DD-MM-YYYY Description Accumulated to DD-MM-YYYY

ASSETS

INVESTMENT ASSETS (Historical Value)

Savings in Banks
On-call Deposits in Banks
Time Deposits in Banks
Bank Certificates of Deposit
Securities issued by Bank Indonesia
Government Securities
Shares listed on the Indonesia Stock Exchange
Corporate Bonds listed on the Indonesia Stock Exchange
Corporate Sukuk listed on the Indonesia Stock Exchange
Regional Bonds/Sukuk
Mutual Funds
Medium Term Notes (MTN)
Asset-Backed Securities
Real Estate Investment Funds in the form of Collective Investment Contracts
Infrastructure Investment Funds in the form of Collective Investment Contracts
Options contracts and equity futures contracts listed on the Indonesia Stock Exchange
REPO
Direct Participation
Land in Indonesia
Buildings in Indonesia
Land and Buildings in Indonesia
Accumulated Depreciation of Buildings
TOTAL INVESTMENT ASSETS
INVESTMENT VALUATION DIFFERENCE

CURRENT ASSETS EXCLUDING INVESTMENTS

Cash and Banks
Contribution Receivables
- Normal Contributions from Employers
- Normal Contributions from Participants
- Voluntary Contributions from Participants
Receivables for Late Contribution Interest
Prepaid Expenses
Investment Receivables
Investment Income Receivables
Other Receivables
TOTAL CURRENT ASSETS EXCLUDING INVESTMENTS

OPERATIONAL ASSETS

Land and Buildings
Vehicles
Computer Equipment
Office Equipment
Other Operational Assets
Accumulated Depreciation
TOTAL OPERATIONAL ASSETS

OTHER ASSETS

TOTAL ASSETS

LIABILITIES

PENSION BENEFIT LIABILITIES

LIABILITIES EXCLUDING PENSION BENEFIT LIABILITIES

Due Pension Benefits and Other Benefits
Voluntary Benefit Payables
Investment Payables
Unearned Revenue
Accrued Expenses
Other Payables
TOTAL LIABILITIES EXCLUDING PENSION BENEFIT LIABILITIES
TOTAL LIABILITIES

Description
DEFINED CONTRIBUTION PENSION PROGRAM BALANCE SHEET As of DD-MM-YYYY Combined Other Benefit Pension Program

PPMP_LPHU
Combined Other Benefit Pension Program

INVESTMENT INCOME

Interest/Profit Sharing
Dividends
Rent
Gain (Loss) on Investment Disposal
Other Investment Income
Total Investment Income

INVESTMENT EXPENSES

Transaction Expenses
Land and Building Maintenance Expenses
Building Depreciation Expenses
Investment Manager Fees
Custodian Fees
Other Investment Expenses
Total Investment Expenses

INVESTMENT OPERATING RESULTS

OPERATIONAL EXPENSES

Employee, Board of Directors, and Supervisory Board Salaries/Honorariums
Office Expenses
Maintenance Expenses
Depreciation Expenses
Third-Party Service Expenses
Other Operational Expenses
Total Operational Expenses

OTHER INCOME AND EXPENSES

Late Contribution Interest Income
Gain (Loss) on Sale of Operational Assets
Gain (Loss) on Sale of Other Assets
Other Income Outside of Investment
Other Expenses Outside of Investment and Operations
Total Other Income and Expenses

INCOME BEFORE TAX
INCOME TAX
NET INCOME

DEFINED CONTRIBUTION PENSION PROGRAM STATEMENT OF COMPREHENSIVE INCOME Accumulated as of DD-MM-YYYY

Description
Accumulated as of DD-MM-YYYY

Combined Other Benefit Pension Program

CASH FLOWS FROM INVESTMENT ACTIVITIES

Receipt of Interest/Profit Sharing
Receipt of Dividends
Receipt of Rent
Other Investment Income
Investment Disposal
Investment Placement
Payment of Investment Expenses
Net Cash Flows from Investment Activities

CASH FLOWS FROM OPERATIONAL ACTIVITIES

Payment of Operational Expenses
Sale of Operational Assets
Purchase of Operational Assets
Sale of Other Assets
Purchase of Other Assets
Other Income Outside of Investment
Other Expenses Outside of Investment and Operations
Income Tax
Net Cash Flows from Operational Activities

CASH FLOWS FROM FINANCING ACTIVITIES

Receipt of Normal Contributions from Employers
Receipt of Normal Contributions from Participants
Receipt of Late Contribution Interest
Receipt of Fund Transfers from Other Pension Funds
Payment of Fund Transfers to Other Pension Funds
Payment of Pension Benefits & Other Benefits
Net Cash Flows from Financing Activities

NET INCREASE (DECREASE) IN CASH
CASH AT BEGINNING OF PERIOD
CASH AT END OF PERIOD

Description
DEFINED CONTRIBUTION PENSION PROGRAM CASH FLOW STATEMENT Accumulated as of DD-MM-YYYY Accumulated as of DD-MM-YYYY

PENSION DEFERRED
COMBINED OTHER BENEFIT PENSION PROGRAM NUMBER OF PENSION FUND PARTICIPANTS As of DD-MM-YYYY

Children
Deferred Pension

b. Founding Partners

Retirees
Widows/Widowers
Children
Deferred Pension

(1) Active Participants a. Founders b. Founding Partners (2) Inactive Participants a. Founders

Retirees

(4) Number of Founding Partner Companies (3) Number of DPPK Participants (1) + (2)

Description

Savings in Banks
On-call Deposits in Banks
Time Deposits in Banks
Bank Certificates of Deposit
Securities issued by Bank Indonesia
Government Securities
Shares listed on the Indonesia Stock Exchange
Corporate Bonds listed on the Indonesia Stock Exchange
Corporate Sukuk listed on the Indonesia Stock Exchange
Regional Bonds/Sukuk
Mutual Funds
MTN
Asset-Backed Securities
Real Estate Investment Funds in the form of Collective Investment Contracts
Infrastructure Investment Funds in the form of Collective Investment Contracts
Options contracts and equity futures contracts listed on the Indonesia Stock Exchange
REPO
Direct Participation
Land in Indonesia
Buildings in Indonesia
Land and Buildings in Indonesia
TOTAL INVESTMENT ASSETS

DEFINED CONTRIBUTION PENSION PROGRAM JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC INVESTMENT RECAPITULATION As of DD-MM-YYYY

Description
Savings | Time Deposits | Certificates of Deposit | SBI | SBN | a | b | c | d | e | f | g

Investment Assets
Number of Participants
Number of Funds

Life Cycle Fund Assets
As of DD-MM-YYYY

Savings in Banks
On-call Deposits in Banks
Time Deposits in Banks
Bank Certificates of Deposit
Securities issued by Bank Indonesia
Government Securities
Shares listed on the Indonesia Stock Exchange Corporate Bonds listed on the Indonesia Stock Exchange Corporate Sukuk listed on the Indonesia Stock Exchange Regional Bonds/Sukuk Mutual Funds MTN Asset-Backed Securities Real Estate Investment Funds in the form of Collective Investment Contracts Infrastructure Investment Funds in the form of Collective Investment Contracts Options contracts and equity futures contracts listed on the Indonesia Stock Exchange REPO Direct Participation Land in Indonesia Buildings in Indonesia Land and Buildings in Indonesia Total

Note:
The "Unrealized Investment Results" column uses data according to the "Increase/Decrease in Investment Value" account on the LPAN sheet.

DEFINED CONTRIBUTION PENSION PROGRAM INVESTMENT RESULTS REPORT As of DD-MM-YYYY

Type of Investment
Realized Investment Results
ROI
Average Investment
Net Investment Results
Investment Expenses
Unrealized Investment Results

Note:
The "Unrealized Investment Results" column uses data according to the "Increase/Decrease in Investment Value" account on the LPAN sheet.

DEFINED CONTRIBUTION PENSION PROGRAM OTHER BENEFIT INVESTMENT RESULTS REPORT As of DD-MM-YYYY

Type of Investment
Realized Investment Results
Unrealized Investment Results
Investment Expenses
Net Investment Results
Average Investment
ROI

A. Investment Assets
Savings in Banks
On-call Deposits in Banks
Time Deposits in Banks
Bank Certificates of Deposit
Securities issued by Bank Indonesia
Government Securities
Shares listed on the Indonesia Stock Exchange Corporate Bonds listed on the Indonesia Stock Exchange Corporate Sukuk listed on the Indonesia Stock Exchange Regional Bonds/Sukuk Mutual Funds MTN Asset-Backed Securities Real Estate Investment Funds in the form of Collective Investment Contracts Infrastructure Investment Funds in the form of Collective Investment Contracts Options contracts and equity futures contracts listed on the Indonesia Stock Exchange REPO Direct Participation Land in Indonesia Buildings in Indonesia Land and Buildings in Indonesia Total Investment

B. Current Assets Excluding Investments Cash & Banks Contribution Receivables Normal Contributions from Employers Normal Contributions from Participants Voluntary Contributions from Participants Receivables for Late Contribution Interest Prepaid Expenses Investment Receivables Investment Income Receivables Other Receivables Total Current Assets Excluding Investments

C. Operational Assets
Land and Buildings
Vehicles
Computer Equipment
Office Equipment
Other Operational Assets
Total Operational Assets

D. Other Assets

E. Total Assets (A+B+C+D)

F. Pension Benefit Liabilities

G. Liabilities Excluding Pension Benefit Liabilities Due Pension Benefits and Other Benefits Voluntary Benefit Payables Investment Payables Unearned Revenue Accrued Expenses Other Payables Total Liabilities Excluding Pension Benefit Liabilities

H. Total Liabilities (F+G)

I. Difference between Total Assets and Total Liabilities (E-H)

J. Percentage (%) of Fund Sufficiency Ratio

DEFINED CONTRIBUTION PENSION PROGRAM ASSET AND LIABILITY RECAPITULATION As of DD-MM-YYYY (in Rupiah)

Maturity >= 10 Years
Description
Maturity < 1 year
1 year <= Maturity < 5 years
5 years <= Maturity < 10 years

Type
Amount
Percentage of Total Investment
a
b
c
d
e
f
g

Investment Details with a Single Counterparty As of DD-MM-YYYY

No
Counterparty Name
Investment
Limit in Investment Guidelines
Investment Limit According to Regulations

Type
Amount
Percentage of Total Investment
a
b
c
d
e
f
g

Investment Details with Affiliated Parties As of DD-MM-YYYY

No
Counterparty Name
Investment
Affiliation Relationship
Notes

Type
Amount
Percentage of Total Investment
a
b
c
d
e
f
g

Note: a. Shares with issuers indicated to be bankrupt b. Mutual Funds indicated to be traded abnormally

Problematic investments can be obtained from the investment balance with problematic parties from the Pension Fund Financial Statements. Information on investees experiencing problems (default risk) can be obtained, among others, from investee financial statements, media disclosures, and/or from rating agencies. Examples of conditions or parties identified as problematic are:
c. Bond issuers or deposit-issuing banks recording losses.
d. There is a downgrade of bond instrument ratings below investment grade. e. There is a delay in coupon payments for Bonds or interest on Deposits. f. Bond issuers or deposit issuers involved in legal cases or indicated fraud. g. Restructured bonds h. Ownership of Land and/or Buildings not yet in the name of the Pension Fund

Details of Identified Problematic Investments As of DD-MM-YYYY

No
Counterparty Name
Investment
Problematic Category
Notes

Name
Type of Investment
Balance
Name
Type of Investment
Security Series
Type of Ownership
Rating
Balance
Name
Type of Investment
Investment Manager
Fair Value
% of SBN in Mutual Funds
Balance
Name
Type of Investment
Investment Manager
Fund Recipient/Project
Balance
Name
Type of Investment
Security Series
Type of Ownership
Rating
Balance
Name
Type of Investment
Balance
…..
Total

DETAILS OF COMPLIANCE WITH REGULATIONS REGARDING SBN INVESTMENTS SBN INFRASTRUCTURE BONDS/SUKUK MUTUAL FUNDS UNDERLYING SBN LIMITED PARTICIPATION FUNDS ASSET-BACKED SECURITIES OTHER INVESTMENTS FOR GOVERNMENT INFRASTRUCTURE PROJECT FINANCING

Investment Income Ratio (ROI)
A. Total Investment Income – Investment Expenses B. Average Investment
C. Ratio (A:B)

Investment Income Ratio to Assets (ROA) A. Total Investment Income + Income Outside Investment) – (Investment Expenses + Operational Expenses + Expenses Outside Investment and Operations) B. Average Available Assets
C. Ratio (A:B)

Operational Expense Ratio (BOPO)
A. Operational Expenses
B. Investment Income + Income Outside Investment
C. Ratio (A:B)

Contribution Receivable Age Ratio (RUPI) A. Contribution Receivables (LAN) x Number of Months Elapsed B. Due Contributions (LPAN)
C. Ratio (A:B)

Investment to Net Assets Ratio (RITA) A. Total Investment x 100% B. Total Net Assets
C. Ratio (A:B)

Investment Receivables and Investment Income Receivables to Total Investment A. Investment Receivables + Investment Income Receivables B. Total Investment
C. Ratio (A:B)

Investment Growth Ratio
A. (Total Investment t1 - Total Investment t0) x 100% B. Total Investment t0
C. Ratio (A:B)

Market Price Changes in Pension Fund Assets A. (SPI_n - SPI_n-1) x 100% B. SPI_n-1
C. Ratio (A:B)

SPI compared to Total Income
A. SPI
B. Total Income
C. Ratio (A:B)

SPI compared to Net Assets
A. SPI
B. Net Assets
C. Ratio (A:B)

Minimum Liquidity Ratio / Cash Ratio A. Current Assets or Investments for Minimum Liquidity Fulfillment B. Operational Costs + Investment Costs + Pension Benefits and Other Benefits Due within one year
C. Ratio (A:B)

Cash Inflows compared to Cash Outflows A. Cash Inflows from Investment, Operational, and Financing Activities B. Cash Outflows from Investment, Operational, and Financing Activities
C. Ratio (A:B)

Contribution Receivable Ratio to Net Assets A. Contribution Receivables B. Net Assets
C. Ratio (A:B)

Growth Ratio of Founder Contribution Receivables (Employer Contributions + Additional Contributions) A. (Total Founder Contribution Receivables t1 - Total Founder Contribution Receivables t0) X 100% B. Total Founder Contribution Receivables t0
C. Ratio (A:B)

Ratio of Total Long-Term Assets to Total Long-Term Liabilities A. Total Long-Term Assets x 100% B. Total Long-Term Liabilities
C. Ratio (A:B)

Income to Expenditure Ratio
A. Operational Expenses + Investment Expenses + Pension Benefit Payments B. Total Income
C. Ratio (A:B)

Interest Rate Spread
A. Investment Income Ratio (ROI)
B. Actuarial Interest Rate
C. Ratio (A-B)

Current Assets Ratio to Total Assets A. Current Assets B. Total Assets
C. Ratio (A:B)

Current Liabilities Ratio to Total Liabilities A. Current Liabilities B. Total Liabilities
C. Ratio (A:B)

Operating Expense Ratio
A. Operational Expenses + Investment Expenses B. Investment Income
C. Ratio (A:B)

Comparison between long-term assets and long-term liabilities is derived from the Pension Fund Financial Statements.
Assets with a life > 1 year are based on information as stated in the Pension Fund Financial Statements.
Liabilities with a life > 1 year are based on information as stated in the Pension Fund Financial Statements.
Current assets are assets with a maturity of less than 1 year (excluding operational assets and other assets) as presented in the Pension Fund Financial Statements.
Total assets are available assets as presented in the Pension Fund Financial Statements.
Current liabilities are liabilities with a maturity of less than 1 year as presented in the Pension Fund Financial Statements.
Total Liabilities are the Actuarial Present Value for PPMP and Pension Benefit Liabilities for PPIP.
Operational expenses are as presented in the Statement of Changes in Net Assets.
Investment expenses are as presented in the Statement of Changes in Net Assets.
Investment income includes realized and unrealized investment income as presented in the Statement of Changes in Net Assets.
Total Investment Income is as presented in the Statement of Changes in Net Assets.
Investment Expenses are as presented in the Statement of Changes in Net Assets.
For the calculation of average investment, the average investment assets throughout the year are used.
Total Investment Income is income that is already realized and unrealized. Total Investment Income is as presented in the Statement of Changes in Net Assets.
Income outside of Investment is as presented in the Statement of Changes in Net Assets.
Investment is as presented in the Net Asset Statement.
For the calculation of Operational Expenses, it is as presented in the Statement of Changes in Net Assets.
For the calculation of total available assets, the average assets throughout the year are used. Total Available Assets are as presented in the Net Asset Statement.
Operational expenses as stated in the statement of changes in net assets.
Investment Income is realized income as stated in the statement of changes in net assets.
Income outside of Investment as stated in the statement of changes in net assets.
SPI is the Investment Valuation Difference for instruments exposed to market risk that are actively traded. Examples: investments in the capital market and deposits denominated in foreign currency.
Total Income is total realized and unrealized income on the statement of changes in net assets.
SPI is the Investment Valuation Difference for instruments exposed to market risk that are actively traded.
Example: investments in the capital market and deposits denominated in foreign currency.
Cash Flows from investment activities are all investment activities except placement and disposal of investments as presented in the financial statements.
Cash Flows from operational activities are all operational activities except placement and disposal of operational assets and other assets as presented in the financial statements.
Cash Flows from financing activities are as presented in the financial statements.

FINANCIAL RATIOS
As of DD-MM-YYYY

Description
Combined Other Benefit Program
Total
Notes

(in millions of Rupiah)

Bill Number
Nominal
Date
Maturity Date
Acquisition Value
Fair Value
Maturity Date
Total
Notes

PENSION FUNDS
PERIODIC PENSION BENEFIT INVESTMENT REPORT

Bank Name/Serial Number
SBN
Deposits
SBN
Total

Number of Participants
MP
Periodic
Number of MP Simultaneously

Initial Reserve (20%)

No.
Investment Manager Name
Contract Number
Contract Date
Contract Period
Type of Investment
Number
Fair Value of Funds Managed (Rp)
Acquisition Value
(managed by Investment Manager)
Investment Valuation Difference
Return (%)
Net Investment Yield (Rp)
Total Management Fees Charged (Rp) Affiliated with Pension Fund (Yes/No)

*: if using Investment Manager services

Fund Management Contract (KPD) Format by Investment Manager* Pension Fund …..

Use of Investment Manager
As of DD-MM-YYYY

Total
etc.

Self-Managed / KPD
Investment Manager Name
a
b
c
d
e
f
g
h
i
j
k
…
Total

Notes

SAVINGS DETAILS

No.
Bank Name
Branch
Bank Code
Acquisition Date
Nominal Value
Interest Rate/Nisbah
Pension Program/Other Benefits
Management

Self-Managed / KPD
Investment Manager Name
a
b
c
d
e
f
g
h
i
j
k
l
…
Total

Notes

ON-CALL DEPOSIT DETAILS

No.
Bank Name
Branch
Bank Code
Acquisition Date
Nominal Value
Tenor
Interest Rate/Nisbah
Pension Program/Other Benefits
Management

Self-Managed / KPD
Investment Manager Name
a
b
c
d
e
f
g
h
i
j
k
l
…
Total

Notes

TIME DEPOSIT DETAILS

No.
Bank Name
Branch
Bank Code
Acquisition Date
Nominal Value
Tenor
Interest Rate/Nisbah
Pension Program/Other Benefits
Management

a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
p
…
Total

Currency Type

Self-Managed / KPD
Investment Manager Name

FOREIGN CURRENCY TIME DEPOSIT DETAILS

No.
Bank Name
Branch
Bank Code
Acquisition Date
Nominal Value
Fair Value
Investment Valuation Difference
Tenor
Interest Rate/Nisbah
Pension Program/Other Benefits
Management

Notes

Value
%

Self-Managed / KPD
Investment Manager Name
a
b
c
d
e
f
g
h
i
j
k
l
…
Total

Notes

CERTIFICATE OF DEPOSIT DETAILS

No.
Bank Name
Branch
Bank Code
Acquisition Date
Nominal Value
Tenor
Interest Rate/Nisbah
Pension Program/Other Benefits
Management

Value
%

Self-Managed / KPD
Investment Manager Name
a
b
c
d
e
f
g
h
i
j
k
l
m
n
…
Total

Pension Program/Other Benefits

Notes
Management

INDONESIAN SECURITIES DETAILS

No.
Security Code
Acquisition Date
Nominal Value
Coupon (%)
Maturity Date
Acquisition Value
Fair Value
Investment Valuation Difference

Value
%

Self-Managed / KPD
Investment Manager Name
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
…
Total

Pension Program/Other Benefits

Accounting Method

Notes
Management

GOVERNMENT SECURITIES DETAILS

No.
Security Code
Acquisition Date
Nominal Value
Coupon (%)
Maturity Date
Acquisition Value
Fair Value
Investment Valuation Difference

Value
%

Self-Managed / KPD
Investment Manager Name
a
b
c
d
e
f
g
h
i
j
k
l
m
n
…
Total

Pension Program/Other Benefits

Notes
Management

SHARES DETAILS

No.
Share Code
Issuer Name
Acquisition Date
Number of Shares
Acquisition Value
Market Value
Investment Valuation Difference
Economic Sector

Beginning
End
Value
%

Self-Managed / KPD
Investment Manager Name
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
p
q
r
s
t
…
Total

Accounting Method

BONDS DETAILS

No.
Issuer Name
Bond Code
Bond Name
Acquisition Date
Nominal Value
Coupon (%)
Maturity Date
Rating
Notes
Management
Acquisition Value
Fair Value
Investment Valuation Difference
Economic Sector

Pension Program/Other Benefits

Beginning
End
Value
%

Self-Managed / KPD
Investment Manager Name
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
p
q
r
s
t
…
Total

Accounting Method

SUKUK DETAILS

No.
Issuer Name
Sukuk Code
Sukuk Name
Acquisition Date
Nominal Value
Coupon (%)
Maturity Date
Rating

Notes
Management
Acquisition Value
Fair Value
Investment Valuation Difference
Economic Sector

Pension Program/Other Benefits

Beginning
End
Value
%

Self-Managed / KPD
Investment Manager Name
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
p
q
r
s
t
…
Total

Notes
Management
Acquisition Value
Fair Value
Investment Valuation Difference
Economic Sector

Pension Program/Other Benefits

Accounting Method

REGIONAL BOND/SUKUK DETAILS

No.
Issuer Name
Regional Bond/Sukuk Code
Regional Bond/Sukuk Name
Acquisition Date
Nominal Value
Coupon (%)
Maturity Date
Rating

Value
%

Self-Managed / KPD
Investment Manager Name
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
…
Total

*) letter d:
Filled with Type of Mutual Fund is Money Market Mutual Fund/Fixed Income Mutual Fund/Mixed Mutual Fund/Equity Mutual Fund/Protected Mutual Fund/Guaranteed Mutual Fund/Index Mutual Fund/Collective Investment Contract Limited Participation Mutual Fund/ and Mutual Funds whose Shares/Units are Traded on the Stock Exchange

Management

MUTUAL FUND DETAILS

No.
Code
Product Name
Type of Mutual Fund
*)
Investment Manager
Acquisition Date
Number of Units
Acquisition Value
Fair Value
Investment Valuation Difference

Pension Program/Other Benefits

Notes

Beginning
End
Value
%

Self-Managed / KPD
Investment Manager Name
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
p
q
r
s
…
Total

Pension Program/Other Benefits

Notes
Management

MTN DETAILS

No.
Code
Product Name
Issuer Name
Acquisition Date
Nominal Value
Coupon (%)
Maturity Date
Rating

Acquisition Value
Fair Value
Investment Valuation Difference

Economic Sector

Beginning
End
Value
%

Self-Managed / KPD
Investment Manager Name
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
p
q
r
s
…
Total

Pension Program/Other Benefits

Notes
Management

Economic Sector
Nominal Value

ASSET-BACKED SECURITIES DETAILS

No.
Code
Product Name
Issuer Name
Acquisition Date
Coupon (%)
Maturity Date
Rating

Acquisition Value
Fair Value
Investment Valuation Difference

Value
%

Self-Managed / KPD
Investment Manager Name
a
b
c
d
e
f
g
h
i
j
k
l
m
n
…
Total

Pension Program/Other Benefits

Notes
Management

REAL ESTATE INVESTMENT FUNDS IN THE FORM OF COLLECTIVE INVESTMENT CONTRACTS DETAILS

No.
Code
Product Name
Investment Manager
Acquisition Date
Number of Units
Acquisition Value
Fair Value
Investment Valuation Difference

% Self-Managed/ KPD Investment Manager Name a b c d e f g h i j k l m n … Total Pension Program/ Other Benefits Description DETAILS OF INFRASTRUCTURE INVESTMENT FUNDS IN THE FORM OF COLLECTIVE INVESTMENT CONTRACTS No Code Product Name Investment Manager Acquisition Date Number of Units Acquisition Value Net Asset Value Investment Valuation Difference % Self-Managed/ KPD Investment Manager Name a b c d e f g h i j k l m … Total Description Management DETAILS OF OPTIONS CONTRACTS AND FINANCIAL FUTURES CONTRACTS LISTED ON THE INDONESIA STOCK EXCHANGE No Issuer Name Buyer Name Acquisition Date Duration Acquisition Value Fair Value Investment Valuation Difference Pension Program/ Other Benefits Beginning End Nominal % Value % Self-Managed/ KPD Investment Manager Name a b c d e f g h i j k l m n o p q r s t … Total Pension Program/ Other Benefits Description Management DETAILS OF REPO No Counterparty Collateral Type (Government Bonds/SBI/Bonds) Acquisition Date Collateral Value Rating Duration Category (KSEI/BIS4) Acquisition Value Margin Amortized Cost Sale Value Investment Valuation Difference Name Position Date % Ownership Total % Ownership Total Date % Ownership Total Value % a b c d e f g h i j k l m n o p q r … Total Self-Managed/ KPD Investment Manager Name Pension Fund Founders Founder Partners Board Members Beneficiaries Unions Whose Members Are DP Participants Others Founders Founder Partners Board Members Beneficiaries Unions Whose Members Are DP Participants Others s t u v w x y z a1 b1 c1 d1 e1 f1 g1 h1 i1 j1 k1 … Total ) letter e :
Filled with Domestic LJK/Non-Domestic LJK/Foreign LJK/Non-Foreign LJK Appraisal/Fair Value Investment Valuation Difference Economic Sector Pension Program/ Other Benefits DETAILS OF DIRECT PARTICIPATION Total Paid-Up Capital Ownership Percentage (v) Subsidiaries of Direct Participation (2) Total Paid-Up Capital Subsidiaries of Direct Participation Ownership Percentage (e1) No Management Description No Company Name (1) Pension Fund Representative Participation Category) Acquisition Date Initial Placement Acquisition Value As of Report Date % Self-Managed/ KPD Investment Manager Name a b c d e f g h i j k l m n o p q r s t u … Total Management Object Type (Land/Building/Land&Building) Book Value Appraisal Value/ Fair Value Appraisal Year Appraiser Name Public/Independent KJPP Name Investment Valuation Difference DETAILS OF LAND, BUILDINGS, OR LAND AND BUILDINGS IN INDONESIA No Address Location (City, Province) Area Type of Proof of Ownership Ownership Document Number Acquisition Date Acquisition Value Accumulated Depreciation Pension Program/ Other Benefits Description No Cash/Bank Name Branch Bank Code Account Number Nominal Pension Program/ Other Benefits Description (Purpose of use) a b c d e f g h … Total DETAILS OF CASH AND BANK Age of Receivables <=3 Months Age of Receivables >3 Months Total Age of Receivables <=3 Months Age of Receivables >3 Months Total a b c d e f g h i j k … Total DETAILS OF CONTRIBUTION RECEIVABLES No Employer Name (Founder/Partner Founder) Employer Contribution Receivables Participant Contribution Receivables Participant Voluntary Contribution Receivables Pension Program/ Other Benefits Description a b c d e f … Total DETAILS OF INTEREST RECEIVABLES FOR DELAYED CONTRIBUTIONS No Employer Name (Founder/Partner Founder) Participant Contribution Interest Receivables Employer Contribution Interest Receivables Pension Program/ Other Benefits Description No Expense Type Amount Pension Program/ Other Benefits Description a b c d e … Total DETAILS OF PREPAID EXPENSES No Investment Receivable Type Party Nominal Pension Program/ Other Benefits Description a b c d e f … Total DETAILS OF INVESTMENT RECEIVABLES No Investment Return Receivable Type Party Nominal Pension Program/ Other Benefits Description a b c d e f … Total DETAILS OF INVESTMENT RETURN RECEIVABLES No Other Receivable Type Party Nominal Pension Program/ Other Benefits Description a b c d e f … Total DETAILS OF OTHER RECEIVABLES No Object Type (Land/Building/Land &Building) Certificate Number Address Location Acquisition Date Acquisition Value Accumulated Depreciation Book Value Acquisition Value on Report Date Description a b c d e f g h i j … Total DETAILS OF LAND AND BUILDINGS No Vehicle Plate No Vehicle Type Acquisition Date Acquisition Value Accumulated Depreciation Book Value Description a b c d e f g h … Total DETAILS OF VEHICLES No Computer Equipment Type Acquisition Date Acquisition Value Accumulated Depreciation Book Value Description a b c d e f g … Total
DETAILS OF COMPUTER EQUIPMENT No Office Equipment Type Acquisition Date Acquisition Value Accumulated Depreciation Book Value Description a b c d e f g … Total DETAILS OF OFFICE EQUIPMENT No Other Operational Asset Type Acquisition Date Acquisition Value Accumulated Depreciation Book Value Description a b c d e f g … Total DETAILS OF OTHER OPERATIONAL ASSETS No Other Asset Type Acquisition Date Asset Value Description a b c d e … Total Other Assets Detail <= 1 year >1 year Total a b c d e f … Total DETAILS OF DUE PENSION BENEFIT LIABILITIES No Amount Pension Program/ Other Benefits Description <= 1 year >1 year Total a b c d e … Total DETAILS OF DUE VOLUNTARY PENSION BENEFIT LIABILITIES No Amount Description No Investment Type Party Value Pension Program/ Other Benefits Description a b c d e f … Total DETAILS OF INVESTMENT LIABILITIES No Advance Income Details Party Value Pension Program/ Other Benefits Description a b c d e f … Total DETAILS OF ADVANCE RECEIVED INCOME No Expenses Still Payable Details Party Value Pension Program/ Other Benefits Description a b c d e f … Total DETAILS OF EXPENSES STILL PAYABLE No Other Liability Type Party Value Pension Program/ Other Benefits Description a b c d e f … Total DETAILS OF OTHER LIABILITIES No. Investment Type Investment Valuation Difference Increase/ Decrease Pension Program/ Other Benefits Description a b c d e f ... Total Investment Increase/Decrease Detail % Amount % Amount a b c d e f g h i j k l m n o ... Total Pension Program/ Other Benefits Description Normal Contributions Participant Normal Contributions Employer Voluntary Contributions Participant Normal Contributions Participant Normal Contributions Employer Voluntary Contributions Participant Normal Contributions Participant Normal Contributions Employer Detail of Due Contributions No. Founder Name/ Partner Founder PhDP Due Contributions Contribution Receipt Underpayment/Overpayment No. Investment Income Type Amount Pension Program/ Other Benefits Description a b c d e ... Total Detail of Non-Investment Income No. Pension Fund Name that transfers Amount Pension Program/ Other Benefits Other Benefits Detail *) Description a b c d e f ... Total *) letter e:
Detail of Transfers from Other Pension Funds Filled with Education Fund/Housing Fund/Religious Worship Fund/Disability Assistance/Death Assistance/Health Assistance/Severance Fund/Additional Benefit Fund No. Expense Type Amount Pension Program/ Other Benefits Description a b c d e ... Total Investment Expense Detail No. Expense Type Amount Pension Program/ Other Benefits Description a b c d e ... Total Operational Expense Detail No. Expense Type Amount Pension Program/ Other Benefits Description a b c d e ... Total Detail of Expenses Outside Investment and Operations No. Income Tax Type Amount Pension Program/ Other Benefits Description a b c d e Total Income Tax Detail No. Pension Fund receiving Transfer Amount Pension Program/ Other Benefits Other Benefits Detail *) Description a b c d e f ... Total *) letter e:
Detail of Transfers to Other Pension Funds Filled with Education Fund/Housing Fund/Religious Worship Fund/Disability Assistance/Death Assistance/Health Assistance/Severance Fund/Additional Benefit Fund FORMAT I C FORMAT AND STRUCTURE OF ANNUAL REPORTS FOR TECHNICAL REPORTS OF EMPLOYER PENSION FUNDS
I. Pension Fund Profile
A. General Profile
Pension Fund Name :
General Register Book Number
(NBDU)
: SID Number :
Taxpayer Identification Number (NPWP) :
Address :
a. Building/Floor/Room/Street :
b. City :
Postal Code :
c. Province :
d. Telephone 1 (area code-phone) :
e. Telephone 2 (area code-phone) :
f. Telephone 3 (area code-phone) :
g. Facsimile (area code - facsimile)
: h. Email :
i. Website :
B. Founders
Founder Name :
Address :
a. Building/Floor/Room/Street :
b. City :
Postal Code :
c. Province :
d. Telephone 1 (area code-phone) :
e. Telephone 2 (area code-phone) :
f. Telephone 3 (area code-phone) :
g. Facsimile (area code - facsimile)
: h. Email :
i. Website :
j. Founder Business Field :
k. Founder Ownership Status
(State-Owned/Non-State-Owned)
: l. Partner Founder (Yes/No) :
C. Organization

Management
a. Is there any change in Board members or extension of Board tenure during the activity period? If Yes, has this matter been reported to OJK?

b. Do Board members have basic knowledge certificates in the field of Pension Funds
c. Do Board members who
have basic knowledge certificates in the field of Pension Funds meet the minimum continuing education points? d. Is there any change in the Supervisory Board or extension of Supervisory Board tenure during the activity period? If Yes, has this matter been reported to OJK ? e. Do the number and composition of Board members and Supervisory Board members comply with PDP and legislation in the field of Pension Funds? f. Do Board members have Investment Field certificates and/or Risk Management?
2. Number of Pension Fund Employees Based on Education Level
SD
: SMP
: SMA
: Diploma
: S1
: S2
: S3
: Total
: 3. List of Names and Positions of Pension Fund Employees Under the Board Organizational Structure
4. Third-Party Service Users:
No. Name Position a. Does the Pension Fund use third-party services to manage membership administration? If Yes, fill in the name information of Membership Administration Manager: 123 5 onwards b. Does the Pension Fund use third-party services to entrust ownership documents of wealth If Yes, fill in the name information of the beneficiary used 5 onwards
c. Does the Pension Fund
use Investment Manager services?
If Yes, fill in the list of names of Investment Managers used (sorted by asset management portion) 5 onwards d. Does the Pension Fund use Appraiser services? If Yes, fill in the list information of Appraisers used:
5 onwards
5. Contributions
a. Does the Employer pay contributions accurately in amount? b. Does the Employer pay contributions on time?
c. Are there voluntary contributions
from Participants?
6. Other Benefits
Does the Pension Fund organize an Other Benefits program for Participants?
7. Investments
a. Are investment activities during the reporting period compliant with regulations per legislation?

b. Has information regarding investments been communicated to participants?
c. Information on Number and
Date/Month/Year of Last Setting
Investment Guidelines
8. Governance
a. Does the Pension Fund have a Pension Fund Governance Guideline? b. Has the Pension Fund implemented Pension Fund Governance?
c. Information on Number and
Date/Month/Year of Governance Guideline Setting D. Pension Fund Membership

Number of Active Pension Fund Employee Participants at the end
of the activity period:
Founders (persons) :
a. Pension Program :
b. Other Benefits :
Partner Founders (persons) :
a. Pension Program :
b. Other Benefits :
Total (persons) :
a. Pension Program :
b. Other Benefits :
Total number of participants entitled to deferred pension
pension program at the end of the activity period : 3. Active Pension Program Participant Age Structure a. Number of Active Participants up to 20 :
20 up to 30 :
30 up to 40 :
40 up to 50 :
above 50 :
b. Number of Participants entitled to deferred pension pension program up to 20 :
20 up to 30 :
30 up to 40 :
40 up to 50 :
above 50 :
Estimated number of pension program participants entering retirement age : normal in one subsequent activity period
Number of Partner Founders
E. Pensioners and Parties Entitled to Pension Program Description Amount ≤ Rp 1,600,000 ,00

Rp
1,600,000
,00
≤ Rp
500,000,000,
Rp
500,000,000,

Number of Benefit Recipients -
a. Number of Benefit Recipients
Pension monthly at the end of the activity period (including those who choose maximum first payment 20%) -
i. Pensioners
ii. Widows/Widowers
iii. Children
iv. Parties designated by
Participant or pensioner if
Participant or pensioner is not married and has no children b. Number of Benefit Recipients Pension who receive lump-sum payments during the activity period due to:
i. Monthly pension benefits
below the limit according to regulations per legislation in the field of Pension Funds

ii. Reasons other than
item b (i)
c. Number of Benefit Recipients
Pension undergoing annuity purchase during the period
2. Distribution of the number of
pension benefit recipients based on categories of large pension benefits received monthly at the end of the activity period
i. Pensioners
(persons)
ii. Widows/Widowers
iii. Children
iv. Parties designated by
Participant or pensioner if Participant or pensioner is not married and has no children Board Statement We, the Board of the Pension Fund, declare that all data and descriptions we provide in this technical report are true data and correspond to the actual conditions of the Pension Fund. If it is later discovered that there is data/description that does not match the actual conditions, we are willing to be held accountable according to regulations per legislation. Place, Date (date/month/year) (signature) Full Name Position
II. Report on Investment Performance Evaluation of the Pension Fund by the Supervisory Board
Acknowledged,
(Signature)
(Name)
(Supervisory Board Position)
(substance of the report is filled out and signed by the Supervisory Board with consideration of Reasonableness of Reasons provided by the Board in explaining the inconsistency of Pension Fund Investment Performance with Investment Guidelines and Annual Investment Plan)
III. Report on the Implementation of Good Corporate Governance for Pension Funds

Transparency of Good Corporate Governance Implementation for
Pension Funds a. DPPK Board Members

Number, name, position, criteria, appointment date, tenure,
citizenship, and domicile of DPPK Board members No. Name Position Criteria Appointment Date Tenure Citizenship Domicile Last Formal Education And Professional Degree Competency Test And Fit and Proper Test 1. 2. Etc.
Concurrent positions of DPPK Board Members
No. Name
Position at
Pension Fund
Position at Another
Pension Fund
Position at
Company and/or institution other

Etc.
2.
1.
2.
Etc.
Etc.
3) Frequency of DPPK Board meetings held in 1 (one)
month.
No. Name Position
Number of Board Meetings (... meeting times) % Attendance Physical Attendance Teleconference/Video Conference/Other Electronic Media Facilities 1. 2. Etc.
4) Family relationships between DPPK Board members with each other Board members and/or DPPK Supervisory Board members at the Pension Fund where the DPPK Board member serves.
No. Name
Family Relationship With
Other Board Members Supervisory Board
Yes No Note* Yes No Note*
1.
2.
Etc.
Note:
 Form of family relationship: husband/wife/child/parent/sibling/in-law, etc. b. Supervisory Board

Number, name, position, criteria, appointment date, tenure,
citizenship, and domicile of Supervisory Board members No. Name Position Criteria Appointment Date Tenure Citizenship Domicile Last Formal Education and Professional Degree Competency Test And Fit and Proper Test 1. 2. Etc.
Concurrent positions of Supervisory Board Members
No. Name
Position at
Pension Fund
Position at Another
Pension Fund
Position at
Company and/or institution other

Etc.
2.
1.
2.
Etc.
Etc.
3) Frequency of Supervisory Board meetings held in 1 (one)
month.
No. Name Position
Number of Supervisory Board Meetings
(... meeting times)
% Attendance
Physical Attendance
Teleconference/ Video
Conference /Other Electronic Media
Facilities
1.
2.
Etc.
4) Family relationships between Supervisory Board members with other Supervisory Board members and/or DPPK Board members, where the Supervisory Board member serves.
No. Name
Family Relationship With
Other Supervisory Board Members
DPPK Board Members
Yes No Note* Yes No Note*
1.
2.
Etc.
Note:
 Form of family relationship: husband/wife/child/parent/sibling/in-law, etc.
c. Supervisory Board Supervision Results Report
Supervisory Board activity report on the implementation of Good Corporate Governance for Pension Funds Supervision Results Recommendations  Filled with details of the Supervisory Board's assessment regarding the implementation of Good Corporate Governance for Pension Funds consisting of quantitative and qualitative assessments of Good Corporate Governance for Pension Funds and factors influencing performance, as well as efforts to improve Pension Fund performance, if according to the Supervisory Board's assessment there is a decline in Pension Fund performance d. Committees

Functions under DPPK Board
No.
Name
Function
Member Name
Position*
Work Tenure
Appointment Decree
Number of Meetings in One Year

Internal Audit
Function
1.
2.
Etc.
2.
Risk Management
Function
1.
2.
Etc.
No.
Name
Function
Member Name
Position*
Work Tenure
Appointment Decree
Number of Meetings in One Year
3. Compliance
Function
1.
2.
Etc.
Etc.
2) Committees under the Supervisory Board
No.
Name
Committee
Member Name
Position*
Work Tenure
Appointment Decree
Number of Meetings in One Year
1.
Audit Committee
1.
2.
Etc.
2.
Risk Monitoring Committee
1.
2.
Etc.
3. Nomination and
Remuneration Committee
1.
2.
Etc.
Etc. e. Implementation of external audit function.
No. Description Year n-2 Year n-1 Year n 1.
Public Accounting Firm Name
2. Public Accountant Name
3. Audit Period
4.
Supervisory Board Appointment *)
Note:
 Appointment Date by the Supervisory Board f. Implementation of Remuneration policies and other facilities for DPPK Board members, Supervisory Board members, and Employees. Number of DPPK Board members, Supervisory Board members, and Employees receiving Remuneration packages in 1 (one) year grouped according to income level as follows:
Total Remuneration per person in 1 year *) Number of DPPK Board Members Number of Supervisory Board Members Employees Above Rp2 billion Above Rp1 billion to Rp2 billion Above Rp500 million to Rp1 billion Rp500 million and below Note:
 received in cash g. Outsourcing of Investment Management *) No. Investment Type Company Name Outsourcing Investment Value No. Agreement Number % of total Investment Portfolio 1. 2. Etc. Note:
 Pension Funds only perform Outsourcing of Investment Management in the form of Collective Investment Contracts (KPD) h. Disclosure of other important matters No. Description Checklist *) If Yes, Yes No Explain 1. Resignation or dismissal of external audit
2. Material transactions with related parties )
3.
Ongoing Conflicts of Interest.
4.
Other material information regarding Pension Fund
5. Pension Fund has a compliance function
6. Pension Fund has internal audit
7.
Pension Fund has a risk management function 8.
Pension Fund has an investment management function/unit 9. Pension Fund has a special work unit and/or appoints a PJK official who No. Description Checklist *) If Yes, Yes No Explain is responsible for implementing the APU and PPT program  select one answer by placing a “√” mark Related Parties are individuals or companies/bodies that have control relationships with the Pension Fund, whether directly or indirectly, through ownership, management, and/or financial relationships
2. Self-Assessment of Good Corporate Governance Implementation for Pension Funds
Completion of the Questionnaire on Good Corporate Governance Implementation for Pension Funds is done by the respective Pension Fund. Completion of this questionnaire is done by providing answers to questions/statements in the said questionnaire. Completion Method:
Generally, answers to the Questions/Statements mentioned consist of 5 criteria as follows (except for answers requiring different criteria) :
A= The respective Pension Fund DOES NOT HAVE written policy regarding the Question/Statement mentioned. B= The respective Pension Fund HAS written policy regarding the Question/Statement mentioned, but the policy has NOT been implemented. C= The respective Pension Fund HAS written policy regarding the Question/Statement mentioned, but the policy has NOT been implemented CONSISTENTLY. D= The respective Pension Fund HAS written policy regarding the Question/Statement mentioned, the policy is IMPLEMENTED CONSISTENTLY but has NOT BEEN UPDATED periodically. E= The respective Pension Fund HAS written policy regarding the Question/Statement mentioned and the policy is IMPLEMENTED CONSISTENTLY and UPDATED periodically. Interpretation of Results An assessment is needed to interpret the numbers obtained in answering the questions of this Questionnaire, most of which answers consist of 5 (five) scales ranging from the lowest assessment (A/ No), to the highest assessment (E/ Yes). Specifically for "A/No" answers in assessment criteria required by regulations per legislation (mandatory nature), a minus number is given. For groups of Questions/Statements skipped because "None exist" and which are not "not applicable", in result interpretation they must still be considered by giving the same score as the "A/No" answer. A. BUSINESS ETHICS AND CODE OF CONDUCT

Pension Fund has Vision, Mission and Values
A B C D E
Pension Fund has a Business Ethics Policy which among others:
2.1.General policy directing towards regulations per legislation and applicable codes of ethics A B C D E 2.2.Policy for Pension Fund organs A B C D E 2.3.Policy for employees A B C D E 2.4.Policy for Participants and/or parties entitled to receive pension benefits A B C D E 2.5.Policy for business partners A B C D E 2.6.Policy for fellow pension funds A B C D E
Pension Fund has a Code of Conduct
which is an elaboration of Values and
Business Ethics
A B C D E
Code of Conduct covers guidelines on:
4.1.Conflict of interest A B C D E
4.2.Gifts and donations A B C D E
4.3.Compliance with regulations A B C D E 4.4.Information confidentiality A B C D E 4.5.Reporting of violations and protection for whistleblowers A B C D E
In carrying out their duties, Board, Supervisory Board, and
pension fund employees:
5.1.Make a statement "no conflict of interest" against every decision taken by the party authorized to make decisions No Yes 5.2.Make a statement every year regarding the implementation of the code of conduct established by the Pension Fund No Yes

5.3. Making an annual statement
not to accept or give anything that could influence decision-making. Yes No

The Pension Fund correctly records its assets, liabilities, and own capital (equity) using generally accepted accounting principles as well as special accounting principles applicable to pension funds.
Yes No
Having a complaint system regarding violations of behavioral guidelines, Pension Fund regulations, and relevant statutory provisions, as well as matters related to Participants, which ensures protection for the Reporter.
A B C D E

B. PENSION FUND GOVERNANCE a. Founder and Co-Founder The Founder and Co-Founder have carried out the following according to their respective functions:
1.1. Internal control. A B C D E
1.2. Risk management. A B C D E
1.3. Implementation of Good Corporate Governance (GCG). A B C D E
1.4. Following up on findings from audits and recommendations from units performing the Pension Fund's internal audit function, external audit of the Pension Fund, and/or supervision results from the Financial Services Authority (OJK).
A B C D E

b. Management

Composition of Appointment and Dismissal of Management Members
1.1. The number of Management members has been adjusted to the complexity of the Pension Fund while still considering the effectiveness of decision-making.
Yes No
1.2. Management consists of members who collectively possess competence*) such as:
1.2.a Investment field. Yes No
1.2.b Risk Management field. Yes No
Requirements for Management Members
2.1. Management members meet the provisions of the Articles of Association.
Yes No
2.2. Management members meet the competency and propriety requirements according to the regulations of the supervising authority.
Yes No
2.3. Management members must understand and implement good corporate governance for the Pension Fund.
A B C D E
2.4. Management members are prohibited from exploiting the Pension Fund for personal, family, business group, or other parties' interests that harm the Pension Fund's interests.
Yes No
2.5. Not holding concurrent positions as members of the Supervisory Board or DPS in the same Pension Fund.
Yes No
2.6. Not holding concurrent positions as directors or commissioners or equivalent roles in other companies and/or institutions, except in subsidiary companies where the pension fund holds investments, whether directly or indirectly.
Yes No
2.7. Management members do not hold concurrent positions as Management members, Executive Officers, Supervisory Board members, or DPS in other Pension Funds.
Yes No
Functions of Management
3.1. Administration
3.1.1. Management is fully responsible for the management of the Pension Fund.
A B C D E
3.1.2. Management manages owned resources effectively and efficiently, including ensuring the availability of human resources meeting specific qualifications to perform their functions.
A B C D E
3.1.3. Management considers the legitimate interests of stakeholders.
A B C D E
3.1.4. Management has and complies with rules of procedure and work guidelines (charters) regulated in the Pension Fund Regulation (PDP) and statutory provisions in the Pension Fund sector.
A B C D E
3.1.5. Management members overseeing the compliance function cannot be held concurrently by Management members overseeing the funding, finance, or investment functions, unless the number of Management members is 2 (two), in which case the compliance function may be held concurrently by the Management member overseeing the finance function.
Yes No

3.2. Risk Management
3.2.1. Management formulates and implements a Risk Management System encompassing all aspects of the Pension Fund's activities.
A B C D E
3.2.2. The Pension Fund has a Risk Monitoring Committee and a Risk Management Unit.
Yes No

3.3. Internal Control
3.3.1. The Pension Fund has an internal supervision function.
Yes No
3.3.2. Responsible for the execution of its duties to the Founder and Co-Founder.
Yes No

3.4. Information Technology
3.4.1. The Pension Fund has an integrated computerized administration system.
A B C D E
3.4.2. The Pension Fund has Standard Operating Procedures for the Information Technology section.
A B C D E

Accountability of Management
4.1. Management prepares accountability reports on the management of the Pension Fund in the form of an Annual Report.
Yes No
4.2. Criteria for the Annual Report include:
4.2.1. Containing at least:
a. Financial statements. Yes No b. Pension Fund activity report. Yes No
c. Report on the implementation of good corporate governance for the Pension Fund. Yes No
4.2.2. Obtained approval from the Founder and Co-Founder.
Yes No
4.2.3. Specifically, financial statements must obtain ratification from the Founder and Co-Founder.
Yes No

4.3. Management Meetings
4.3.1. Every strategic policy and decision must be decided through a DPPK Management meeting, considering supervision according to the duties and responsibilities of the Supervisory Board.
Yes No
4.3.2. Management holds meetings periodically at least once every 1 (one) month.
Yes No
4.3.3. Management establishes meeting rules of procedure.
Yes No
4.3.4. Minutes of every Management meeting are recorded.
Yes No
4.3.5. Meeting minutes record dissenting opinions against decisions taken in the meeting (if any).
A B C D E
4.3.6. Every Management member, whether attending or not attending the meeting, is entitled to receive a copy of the Management Meeting Minutes.
Yes No

c. Supervisory Board

Composition, Appointment, and Dismissal of Supervisory Board Members
1.1. The number of Supervisory Board members has been adjusted to the complexity of the Pension Fund while still considering the effectiveness of decision-making.
Yes No
1.2. The entire Supervisory Board consists of members who collectively possess competencies relevant to their positions.
Yes No
1.3. Not holding concurrent positions as Management or DPS in the same Pension Fund, or as Supervisory Board, Management, or DPS in other Pension Funds.
Yes No
Competence and Integrity of the Supervisory Board
2.1. Meet Fit and Proper Test requirements.
Yes No
2.2. Monitor the effectiveness of implementing good corporate governance for the Pension Fund.
A B C D E
2.3. Do not exploit the Pension Fund for personal, family, business group, or other parties' interests that can harm the Pension Fund.
Yes No
Supervisory Functions of the Supervisory Board
3.1. Fully responsible for the supervision of the Pension Fund.
A B C D E
3.2. Execute the duties and responsibilities of the Supervisory Board as regulated in the PDP and statutory provisions in the Pension Fund sector independently.
Yes No
3.3. The Supervisory Board holds meetings periodically at least once every 3 (three) months.
Yes No
3.4. Minutes of every Supervisory Board meeting are recorded.
Yes No
3.5. Meeting minutes record dissenting opinions against decisions taken in the meeting.
A B C D E
3.6. Every Supervisory Board member, whether attending or not attending the meeting, is entitled to receive a copy of the Supervisory Board meeting minutes.
Yes No
Supervisory Board Committees (answered if applicable)
4.1. Audit Committee
No / Continue to 4.1.7.
The Audit Committee serves as a facilitator for the Supervisory Board to ensure the following:
4.1.1. The Pension Fund's internal control structure is implemented properly.
A B C D E
4.1.2. Internal audit is conducted according to applicable audit standards.
A B C D E
4.1.3. Follow-up on internal audit findings is implemented by management.
A B C D E
4.1.4. External audit has been conducted according to applicable auditing standards.
Yes No
4.1.5. Follow-up on external audit findings is implemented by management.
A B C D E
4.1.6. Audit Committee members consist of:
a. Supervisory Board members. Yes No b. Parties outside the Pension Fund who do not have financial, administrative, and/or family relationships with the Supervisory Board, Pension Fund Management, and/or Founder, or other relationships that could affect their ability to act independently. Yes No
4.1.7. For Pension Funds that do not have an Audit Committee, there is a Supervisory Board member specifically tasked to ensure the following:
a. The Pension Fund's internal control structure has been implemented properly. A B C D E b. Internal audit is conducted according to applicable audit standards. A B C D E
c. Follow-up on internal audit findings is implemented by management.
A B C D E d. External audit has been conducted according to applicable audit standards. Yes No e. Follow-up on external audit findings is implemented by management. A B C D E

4.2. Risk Monitoring Committee
No / Continue to 4.2.4.
The Risk Monitoring Committee serves as a facilitator for the Supervisory Board for the following matters:
4.2.1. Assess the quality of risk management policies.
A B C D E
4.2.2. Assess the effectiveness of risk management applied by the Pension Fund, including assessing the risk tolerance taken by Management.
A B C D E
4.2.3. Risk Monitoring Committee members consist of:
a. Supervisory Board members representing Participants. Yes No b. Other parties. Yes No
4.2.4. For Pension Funds that do not have a Risk Monitoring Committee, there is a Supervisory Board member specifically tasked for the following:
a. Assess the quality of risk management policies.
A B C D E b. Assess the effectiveness of risk management applied by the Pension Fund, including assessing the risk tolerance taken by Management. A B C D E

4.3. Nomination and Remuneration Committee
No / Continue to 4.3.4.
The Nomination and Remuneration Committee serves as a facilitator for the Supervisory Board for the following matters:
4.3.1. Facilitator for the Supervisory Board in helping the Founder set criteria and select candidates for the Supervisory Board and Pension Fund Management.
A B C D E
4.3.2. Facilitator for the Supervisory Board in helping the Founder establish the Remuneration system.
A B C D E
4.3.3. Nomination and Remuneration Committee members consist of:
a. Supervisory Board members. Yes No b. Other parties. Yes No
4.3.4. For Pension Funds that do not have a Nomination and Remuneration Committee, there is a Supervisory Board member specifically tasked for the following:
a. Help the Founder set criteria and select candidates for the Supervisory Board and Pension Fund Management. A B C D E b. Help the Founder establish the Remuneration system. A B C D E

C. HEALTHY BUSINESS PRACTICES
External Auditor

External Auditors (public accounting firms) conduct independent examinations of the accuracy of the Pension Fund's financial reports.
Yes No
The designated public accounting firm (KAP) is registered with the Financial Services Authority (OJK).
Yes No
Action Plan
No.
Corrective Action
Target Completion Date
Completion Obstacles
Remarks

...

Implementation of Anti-Fraud Strategy
Name of Pension Fund..............................
FRAUD CONTROL REPORT AND ANTI-FRAUD STRATEGY IMPLEMENTATION YEAR …… a. Inventory of Fraud Incidents and Follow-up Type of Fraud a) Date of Fraud Occurrence Division/Unit of Fraud Occurrence Parties Involved b) Position Losses in Rupiah c) Pension Fund Actions d) Weaknesses/Causes of Fraud e) Follow-up/Improvements f) Chronology of Fraud Incident g) b. Progress of Anti-Fraud Strategy Implementation

Prevention:
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………..................
Detection:
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………..................
Investigation, Reporting, and Sanctions:
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………..................
Monitoring, Evaluation, and Follow-up:
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………..................

EXPLANATIONS FOR REPORT COMPLETION:
a) Types of Fraud include fraud, deception, asset embezzlement, information leakage, criminal acts by the Pension Fund, or others. b) Parties involved include all parties indicated to be involved/participate in the Fraud. If more than 1 (one) party is involved, the role of each party is explained. c) Losses are filled with losses that have occurred or estimated losses. d) Pension Fund actions are the Pension Fund's response to the Fraud incident, either actions against perpetrators, harmed parties, or other actions. Actions against Fraud perpetrators include administrative personnel sanctions and/or compensation obligations. Actions against harmed parties include loss compensation and/or reputation restoration efforts. Other actions include reports to competent authorities and/or legal efforts undertaken. e) Weaknesses/causes of Fraud are identifications of weaknesses in the Pension Fund that caused the Fraud, which can be policy, system, and procedure weaknesses, or human resource weaknesses, or other causes not originating from the Pension Fund. f) Follow-up/improvements are efforts already or to be undertaken by the Pension Fund regarding weaknesses causing Fraud. g) Briefly explain the process of prevention, detection, investigation, reporting, sanctions, and monitoring, evaluation, and follow-up steps in implementing the anti-Fraud strategy during the reporting period.

IV. Evidence of Fulfillment of Continuity Requirements for Management and Employees Handling Investments
FORM :
SELF ASSESSMENT FORM
CONTINUITY REQUIREMENTS COMPLIANCE REPORT FOR MANAGEMENT AND EMPLOYEES HANDLING INVESTMENTS Name of Pension Fund :
Report Letter Number :
Date of Report Letter :
Contact Person (Name,
Tel/email) :
NO DESCRIPTION LEGAL BASIS YES NO REMARKS 1.
The continuity requirement compliance report is submitted by the Pension Fund Management to OJK no later than April 30 of the following year. o POJK 3/POJK.05/2015 o POJK 5/POJK.05/2018 o POJK 29/POJK.05/2018
2. Evidence of fulfillment of continuity requirements
Additional remarks (if necessary):
No Name Type of Principal Party *) *) No and date of SK (FPT) Type of Fulfillment *) Title of Activity Organizer *) Name of Organizer Date of Execution Fulfillment Year Proof of Fulfillment *) ..... o Management o Employee ..... o Attend seminar, workshop, or similar activity o Attend course, training, or similar education program o Write paper, article, or other published written work o Be a speaker in seminar, workshop, or similar activity, be a teacher or instructor in activities ..... o Financial services regulatory body inside and outside the country o Financial services institution association inside and outside the country o Higher education institution inside and outside the country o Training institution obtaining license from competent authority ..... ..... ..... o Certificate (number and date) o Attendance proof o Others,
.....

Course, training, or similar education program Remarks:

How to fill: click twice on the box, then select "Checked"
*) Choose one
) Specifically for management
*) for all employees handling investments
This Self Assessment Form is prepared based on OJK Regulation No. 3/POJK.05/2015 concerning Pension Fund Investments; OJK Regulation No.5/POJK.05/2018 concerning Periodic Pension Fund Reports, and OJK Regulation No.29/POJK.05/2018 concerning Amendments to Financial Services Authority Regulation Number 3/POJK.05/2015 concerning Pension Fund Investments
Types of fulfillment of continuity requirements related to knowledge in the investment and/or risk management fields as regulated in OJK Regulation No. 3/POJK.05/2015 Concerning Pension Fund Investments.

FORMAT ID
FORM AND STRUCTURE OF OTHER EMPLOYER-SPONSORED PENSION FUND REPORTS A. Consumer Service and Complaint Resolution Report on Financial Service Business Actors The form and structure of consumer complaint reports and follow-up service and resolution as referred to in the Financial Services Authority Regulations regarding Consumer Complaint Services in the Financial Services Sector refer to the form and structure contained in the Appendix of the Financial Services Authority Circular Letter regarding Guidelines for Implementation of Consumer Complaint Services in the Financial Services Sector.

B. Report on Appointment of Public Accountants and/or Public Accounting Firms for Audit of Historical Annual Financial Information The form and structure of the report on the appointment of public accountants and/or public accounting firms for the audit of historical annual financial information as referred to in the Financial Services Authority Regulations regarding the Use of Public Accountants and Public Accounting Firms in Financial Services Activities refer to the form and structure contained in the Appendix of the Financial Services Authority Circular Letter regarding Procedures for Using Public Accountants and Public Accounting Firms in Financial Services Activities.

C. Audit Committee Evaluation Report on the Provision of Audit Services for Historical Annual Financial Information by Public Accountants and/or Public Accounting Firms
The form and structure of the Audit Committee's evaluation report on the provision of audit services for historical annual financial information by public accountants and/or public accounting firms as referred to in the Financial Services Authority Regulations regarding the Use of Public Accountants and Public Accounting Firms in Financial Services Activities refer to the form and structure contained in the Appendix of the Financial Services Authority Circular Letter regarding Procedures for Using Public Accountants and Public Accounting Firms in Financial Services Activities.

D. Periodic Actuarial Report a. Actuarial Report for Employer-Sponsored Pension Funds Implementing Defined Benefit Pension Programs General Data Report Number Report Date NBDU Pension Fund Name Pension Fund Address Reporting Period Reporting Month Fiscal Year Type of Reporting Period Annual Report Management Name Management Position

Actuarial Statement
1.1 Pension Fund Actuarial Information:

Actuary Name;
Actuarial Firm Name;
Office Address and Telephone Number;
STTD Consultant Actuary No. (with valid license at IKNB);
1.2 Confirmation regarding Actuarial Present Value, Solvency Liability, Funding Wealth, Surplus or Deficit, Solvency Ratio, Funding Ratio, and funding quality.
1.3 Confirmation regarding:

the amount of Normal Contributions to be paid until the end of the first book year after the actuarial valuation date, detailed for the portion to be paid by Participants and Employers;
the percentage of Normal Contributions against basic pensionable income for years subsequent to the book year referred to in item 1, up to the submission of the next Actuarial Report;
the portion of Normal Contributions whose fulfillment becomes the responsibility of the Employer that can be paid from Surplus occurring, along with its usage period; and
for Periodic Actuarial Reports as referred to in the Financial Services Authority Regulations concerning Pension Fund Financing

1.4 Confirmation regarding the amount of additional monthly contributions along with their payment period.
1.5 Pension Cost Sharing/non cost sharing (Choose one)
I, the undersigned, declare that:

All data received is complete and can be accounted for for the purpose of preparing the Actuarial Report to the extent of the actuary's knowledge, and therefore testing has been conducted to assess its reliability.
The report meets statutory provisions in the Pension Fund sector.
The report meets Employer provisions.
The report was prepared based on PDP; and
The report was prepared based on actuarial practice standards for Pension Funds applicable in Indonesia;
Place, date of creation
Signed.
Name
No. Indonesia Actuaries Association (PAI) Register Public Actuary License No.:
Founder and Co-Founder Statement
We, the undersigned, declare that:
the data and PDP submitted are complete and correct;
we are willing to pay contributions according to the minimum financing stated in the Actuarial statement; and
in case of surplus, it is used to reduce Employer Normal Contributions, including representing the statement of all employers in case of sharing/non-sharing pension cost
Place, date of creation Position*)
Signed.
Name
Actuarial Valuation Date
Actuarial valuation date reported
Actuarial valuation date of previous period
Purpose of Preparation
Summary of PDP and Changes occurring since the previous actuarial valuation date
Summary of number of Participants and eligible persons along with changes since the previous actuarial valuation date
Description DD-MM-YYYY
(reporting period) DD-MM-YYYY
(previous period)
Active Participants
Passive Participants

Retirees
Deferred pensions
Widows/widowers
Children
Designated parties

Actuarial Valuation Method and Actuarial Assumptions Used
Description DD-MM-YYY
(reporting period) DD-MM-YYY
(previous period)
Actuarial Calculation Method
Actuarial Present Value Calculation Method Solvency Liability Calculation Method Economic Assumptions Inflation Rate Interest Rate Basic pensionable income increase rate Pension benefit increase rate Demographic Assumptions Mortality rate during active period Mortality rate during pension period Disability rate Withdrawal rate Other Assumptions Tax (in case tax on pension benefits is borne by the Pension Fund) Spouse age difference Pension program management costs Reasons for selecting actuarial valuation method and actuarial assumptions Reasons if there are changes from those used in the previous actuarial valuation
Overall Actuarial Valuation Results
Actuarial Calculation Results
Description DD-MM-YYYY
(reporting period) DD-MM-YYYY
(previous period) a. Funding Wealth
Wealth
Funding wealth
Liabilities
Solvency Liability
Actuarial Present Value b. Analysis of Surplus or Deficit Changes Financing Position Surplus Surplus excess Surplus usage period Total Deficit Pre-law deficit Deficit categorized as solvency deficiency Extra-budgetary deficit categorized as solvency deficiency Analysis:
Financing Quality Level
Funding Ratio
Solvency Ratio
Contributions
Normal Contribution
First Year (Rp)
Subsequent Years
Participant Normal Contribution (%)
Employer Normal Contribution (%)
Total
Additional Contribution
Monthly Contribution
Installment period (months)
c. Overall Actuarial Valuation Results
Monthly Actuarial Present Value Projection for at least the first 3 (three) years
Name and address of Actuary and explanation whether the Actuary also signed the Actuarial statement in the previous Actuarial Report
b. Actuarial Report for Employer-Sponsored Pension Funds Implementing Defined Contribution Pension Programs and Making Periodic Pension Benefit Payments General Data Report Number Report Date NBDU Pension Fund Name Pension Fund Address Reporting Period Reporting Month Fiscal Year Type of Reporting Period Annual Report Management Name Management Position
Actuarial Statement
1.1 Pension Fund Actuarial Information:

Actuary Name;
Actuarial Firm Name;
Office Address and Telephone Number;
STTD Consultant Actuary No. (with valid license at IKNB);
I, the undersigned, declare that:

All data received is complete and can be accounted for for the purpose of preparing the Actuarial Report to the extent...

actuarial knowledge, and for which testing has been conducted to assess their reliability.
2. The Report has met the provisions of legislation in the field of Pension Funds.
3. The Report has met the provisions of the Employer.
4. The Report has been prepared based on the Actuarial Assumptions; and
5. The Report has been prepared based on actuarial practice standards for Pension Funds in force in Indonesia;

Place, date of preparation
Signature
Name
No. Indonesia Actuarial Association (PAI) Register Public Actuary License No.:

Actuarial Valuation Date
Actuarial valuation date reported
Actuarial valuation date of the previous period
Purpose of Preparation
Summary of Actuarial Assumptions including payment pattern and normal retirement age
Summary of the number of Participants, widows/widowers, and children who chose periodic Pension Benefit payments

Description DD-MM-YYYY
(reporting period)
DD-MM-YYYY
(previous period)
Active Participants
Inactive Participants

Retirees
Deferred Retirees
Widows/Widowers
Children
Designated Parties

Interest Rate Used
Cash Flow Projection
Actuarial Gain or Loss Analysis
Investment Results and Cost Analysis
Conversion Table
Conclusions and Recommendations

c. Actuarial Report for Employer Pension Funds Implementing Other Than Pension Benefits Programs

General Data
Report Number
Reporting Date
NBDU
Pension Fund Name
Pension Fund Address
Reporting Period
Reporting Month
Fiscal Year
Type of Reporting Period Annual Report Management Name Management Position

Actuarial Statement
1.1 Pension Fund Actuarial Information:

Actuary Name;
Actuarial Firm Name;
Office Address and Telephone Number;
STTD Number of Actuarial Consultant (with valid license at OJK);

1.2 Confirmation regarding the program asset value of the Other Than Pension Benefits Program, the present value of potential Other Benefits payments, and the adequacy of the Other Than Pension Benefits Program funding.
1.3 Confirmation regarding the amount of funding required for the implementation of the Other Than Pension Benefits Program.
1.4 Pension cost sharing/non-cost sharing (Choose one)

I, the undersigned, declare that:

All data received is complete and can be accounted for for the purpose of preparing the Actuarial Report to the best of my actuarial knowledge, and for which testing has been conducted to assess their reliability.
The Report has met the provisions of legislation in the field of Pension Funds.
The Report has met the provisions of the Employer.
The Report has been prepared based on the Actuarial Assumptions;
The Report has been prepared based on actuarial practice standards for Pension Funds in force in Indonesia;
The Program Asset Value of the Other Than Pension Benefits Program, the present value of potential Other Benefits payments, and the adequacy of the Other Than Pension Benefits Program funding; and
The amount of funding required for the implementation of the Other Than Pension Benefits Program for each employer.

Place, date of preparation
Signature
Name
No. Indonesia Actuarial Association (PAI) Register Public Actuary License No.:

Founder/Co-Founder Statement
We, the undersigned, declare that:
The Data and Actuarial Assumptions submitted are complete and correct;
We are able to pay contributions in accordance with the minimum funding outlined in the Actuarial Statement; and
In the event of excess funding in the Other Than Pension Benefits Program, it is used to reduce Other Than Pension Benefits Program contributions, including representing all employers in the case of sharing/non-sharing pension costs.

Place, date of preparation Position*)
Signature
Name

Actuarial Valuation Date
Actuarial valuation date reported
Actuarial valuation date of the previous period
Purpose of Preparation
Summary of Actuarial Assumptions and Changes occurring in the Actuarial Assumptions since the previous actuarial valuation date
Summary of the Number of Participants and the number of parties entitled to Other Benefits along with changes occurring since the previous actuarial valuation date

Description DD-MM-YYYY
(reporting period)
DD-MM-YYYY
(previous period)
Active Participants
Inactive Participants

Retirees
Deferred Retirees
Widows/Widowers
Children
Designated Parties

Actuarial Valuation Method and Actuarial Assumptions Used

Description
DD-MM-YYYY
(reporting period)
DD-MM-YYYY
(previous period)
Actuarial Calculation Method
Present Value Calculation Method
Solvency Liability Calculation Method
Economic Assumptions
Inflation Rate
Interest Rate
Rate of increase in basic pensionable earnings Rate of increase in pension benefits Demographic Assumptions Mortality Rate during Active Period Mortality Rate during Retirement Period Disability Rate Withdrawal Rate

Other Assumptions
Tax (in the event that tax on pension benefits is borne by the Pension Fund) Age difference between husband and wife Program management costs

Reasons for selecting the actuarial valuation method and actuarial assumptions Reasons if there are changes from those used in the previous actuarial valuation

Overall Actuarial Valuation Results

Actuarial Calculation Results
Description
DD-MM-YYYY
(reporting period)
DD-MM-YYYY
(previous period) a. Funding Wealth
Wealth
Funding Wealth
Liabilities
Solvency Liability
Actuarial Present Value b. Analysis of Surplus or Deficit Changes Funding Position Surplus Surplus Excess Surplus Utilization Period Total Deficit Pre-Act Deficit Deficit categorized as solvency deficiency Excess Deficit categorized as solvency deficiency

Analysis:
Funding Quality Ratio
Funding Ratio
Solvency Ratio

Contributions
Normal Contribution
First Year (Rp)
Subsequent Years
Participant Normal Contribution (%)

Employer Normal Contribution (%)
Total

Additional Contributions
Monthly Contribution
Installment Period (months)

c. Overall Actuarial Valuation Results

Program Asset Value of the Other Than Pension Benefits Program
Description of the determination of the Program Asset Value of the Other Than Pension Benefits Program
Analysis of changes in the adequacy of the Other Than Pension Benefits Program funding
Projection of the present value of potential Other Benefits payments, semi-annually for the first 3 (three) years at minimum
Amount of funding required for the implementation of the Other Than Pension Benefits Program

E. Pension Fund Business Plan

BUSINESS PLAN REPORT
Year ...............................
(fill in Pension Fund name and address)

Approved,
Supervisory Board
(Pension Fund Stamp)
Name Clearly
Position
20xx
Management,
(Pension Fund Stamp)
Name Clearly
Position

Business Plan Report in accordance with Article 3 paragraph (1) of POJK Number 24/POJK.05/2019 concerning Business Plans of Non-Bank Financial Service Institutions, with a submission deadline no later than November 30 before the Business Plan year begins.

TABLE OF CONTENTS
EMPLOYER PENSION FUND BUSINESS PLAN FORMAT Format 1: Pension Fund Profile Format 2: Executive Summary Format 3: Evaluation of Previous Business Plan Period Implementation Format 4: Vision, Mission, and Business Strategy Format 5: Business Activity Plan Format 6: Business Development or Expansion Plan Format 7: Investment Plan Format 8: Funding Plan Format 9: Office Network and/or Distribution Channel Development and/or Change Plan Format 10: Organizational, Human Resources, and/or Information Technology Development Plan Format 11: Financial Statement Projection Format 12: Projection of Ratios and Certain Other Items, and Assumptions Used Format 13: Other Information

Format 1: Pension Fund Profile

General Pension Fund Information

Pension Fund Name
Pension Fund Code
Approval Decree
Program
Management
Supervisory Board
Office Address
Reporting Date
Business Plan Year

Pension Fund Organizational Structure
(Filled with the Pension Fund organizational structure chart)
General Founder Information

Founder Name
Address
Board of Directors
Board of Commissioners
Business Sector

Format 2: Executive Summary

Short-Term Strategic Plan and Steps for Period 1 (One) Year 1)
................................................................................................................................
................................................................................................................................
..................................................
Medium-Term Strategic Plan and Steps for Period 3 (Three) Years

................................................................................................................................
................................................................................................................................
..................................................
3. Long-Term Strategic Plan and Steps for Period 5 (Five) Years 1)
................................................................................................................................
................................................................................................................................
..................................................
Note:

Includes among others strengthening funding, implementation of good corporate governance for Pension Funds, risk management implementation, and improvement of Pension Fund investment results, reduction of Pension Fund receivables, increase in pension benefits or other benefits, and improvement of Pension Fund efficiency.

Financial Indicators
(in full rupiah units)
No Description Performance
Sept X-1
Projection
Dec X-1 June X Dec X
Net Assets
Investments
Investment Income
Investment Expenses
Operating Expenses
Note:
X-1: year of report preparation.
X: year of business plan position.
Description of Pension Fund Financial Conditions
................................................................................................................................
................................................................................................................................
...............................................

Description of Pension Fund financial conditions reflected in financial indicators and financial ratios, including reasons for increases/decreases.

Financial Ratios
No Description
Performance Sept
X-1
(%) Projection (%)
Dec X-1 June X Dec X

Investment Income Ratio (ROI)
2.
Investment Income to Assets Ratio (ROA) 3.
Operating Expense Ratio (BOPO)
4.
Contribution Receivable Age Ratio (RUPI) 5.
Funding Ratio
(Specific to DB Programs)
6.
Solvency Ratio
(Specific to DB Programs)
Note:
X-1: year of report preparation.
X: year of business plan position.

Format 3: Evaluation of Previous Business Plan Period Implementation

Comparison Between Business Plan and Realization of Business Plan Each Year
(Ignore if your Pension Fund is a new Pension Fund and/or submitting the business plan report for the first time). (Detail the current business plan and its realization with the business plan each year. In this section, the Pension Fund can view its performance in that period by comparing the business plan with the realization of the business plan. The table example below can be modified in more detail according to the Pension Fund's needs.)

Indicator
20XX-1
Business Plan Realization
% Achievement
(1) (2) (2/1)
Net Assets
Investments
Contributions:
a. Participant Normal Contribution b. Participant Voluntary Contribution
c. Employer Normal Contribution
d. Additional Contributions
Pension Benefit Payments
Investment Income
Investment Expenses
Operating Expenses
Investment Income Ratio (ROI)
Investment Income to Assets Ratio (ROA) Operating Expense Ratio (BOPO) Contribution Receivable Age Ratio (RUPI) Funding Ratio (specific to DB Programs) Solvency Ratio (specific to DB Programs)

Challenges Faced and Problem-Solving Efforts*
................................................................................................................................
......................

Clearly state the challenges faced in implementing the established plans and the solutions to those problems.

Problem-Solving Efforts*
................................................................................................................................
................................................................................................................................
..............................

Clearly state the solutions to the problems.

Format 4: Vision, Mission, and Business Strategy

Pension Fund Vision *
.................................................................................................................................
.................................................................................................................................
......................................

Vision is a picture of the Pension Fund's condition in the future and is the Pension Fund's aspiration. Vision is a statement to answer the question of the Pension Fund's direction forward.

Pension Fund Mission *
.................................................................................................................................
.................................................................................................................................
......................................

Mission is an elaboration of the vision, where the mission elaborates a careful analysis of the benefits desired by Participants. The mission also elaborates on the existing environmental and market conditions and the Pension Fund's anticipation forward.

Pension Fund Business Strategy
No Target Policy Strategy
a.

Etc b.
1)
2)
Etc
Etc
2. a.
1)
2)
Etc b.
1)
2)
Etc
Etc

No Target Policy Strategy
Etc

Format 5: Business Activity Plan
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
.................................................
(Plan regarding the implementation of business activities previously carried out by the Pension Fund with reference to legislation concerning the implementation of Pension Funds. Can be added with reasons and considerations in preparing the said plan and strategies to realize the said plan.)

Format 6: Business Development or Expansion Plan (Addition of Benefits Other Than Pension Benefits) No Type Other Benefits General Description Other Benefits Time Implement Other Benefits Purpose Other Benefits Risks over Implement Other Benefits Risk Mitigation over Implement Other Benefits Reasons and Consider ations Strategy Note:
a. Plan for Addition of Other Benefits includes the implementation plan of Other Benefits based on approval from the Financial Services Authority (OJK). b. In accordance with POJK regarding Contributions, Pension Benefits, and Other Benefits Organized by Pension Funds, it can be filled regarding other benefits. Pension Fund business activities categorized as a form of business development or expansion are business activities that:

a. have never been done before by the Pension Fund, such as organizing other benefit programs for Pension Funds that have not yet organized other benefit programs or periodic pension benefit payments by Pension Funds that organize defined contribution programs; or b. have been implemented previously by the Pension Fund, but development is carried out that changes or increases certain Risk exposures on the Pension Fund, such as changes in pension programs for Employer Pension Funds.

Format 7: Investment Plan

Investment Composition

Based on Acquisition Value
No Type of Investment
Actual
Per 30 Sept
20XX-1
Projection
Per 31 Dec
20XX-1
Per 30 Jun
20XX
Per 31 Dec
20XX
Nominal % Nominal % Nominal % Nominal %

Savings
at Banks
On-call Deposits
at Banks
Time Deposits
at Banks
Certificates
of Deposit at
Banks
Securities
issued by
Bank Indonesia
Government
Securities
Stocks listed
on the
Indonesian Stock Exchange
Corporate Bonds
listed on the
Indonesian Stock Exchange
Corporate Sukuk
Listed on

Based on Fair Value
Indonesian Stock Exchange

Regional Bonds/Sukuk
Mutual Funds
MTN
Asset-Backed Securities
Real Estate Investment Funds
in the form of collective investment contracts
Infrastructure Investment Funds
in the form of collective investment contracts
Option Contracts and
Derivative Contracts listed on the
Indonesian Stock Exchange
REPO
Direct Participation
Land in
Indonesia
Buildings in
Indonesia
Land and
Buildings in
Indonesia
No Type of Investment
Actual
Per 30 Sept
20XX-1
Projection
Per 31 Dec
20XX-1
Per 30 Jun
20XX
Per 31 Dec
20XX
Nominal % Nominal % Nominal % Nominal %
Savings
at Banks
On-call Deposits
at Banks
Time Deposits
at Banks
Certificates
of Deposit at
Banks
Securities
issued by
Bank Indonesia
Government
Securities
Stocks listed
on the
Indonesian Stock Exchange
Corporate Bonds
listed on the
Indonesian Stock Exchange
Corporate Sukuk
Listed on
Indonesian Stock Exchange
Regional Bonds/Sukuk
Mutual Funds
MTN
Asset-Backed Securities
Real Estate Investment Funds
in the form of collective investment contracts
Infrastructure Investment Funds
in the form of collective investment contracts
Option Contracts and
Derivative
Investment Results Plan
No
Type of
Investment
Actual Projection
Per 30 Sept 20XX-1 Per 31 Dec 20XX-1 Per 30 Jun 20XX Per 31 Dec 20XX Invest ment Result Real Invest ment Result Unr alized Invest ment Expense Invest ment Result Net Invest ment Result Real Invest ment Result Unr alized Invest ment Expense Invest ment Result Net Invest ment Result Real Invest ment Result Unr alized Invest ment Expense Invest ment Result Net Invest ment Result Real Invest ment Result Unr alized Invest ment Expense Invest ment Result Net Invest ment Result Real Invest ment Result Unr alized Invest ment Expense Invest ment Result Net Invest ment Result a b c d=(a +b)- c a b c d=(a +b)- c a b c d=(a +b)- c a b c d=(a +b)- c
Savings
at
Banks
Depo
sito on call at
Banks
Depo
sito
Time at
Banks
Certif
icates
Depo sito at
Banks
Securi
ties
Issu ed by
Bank
Indon esia
Securi
ties
Govt
Stoc
ks
Listed on
Stoc k
Exch ange in
Indon esia
Corp
orate
Bond s
Listed on
Stoc k
Exch ange in
Indon esia
Corp
orate
Suk uk
Listed on
Stoc k
Exch ange in
Indon esia
.
Regi onal
Bond s/S ukuk
.
Mut ual
Fun ds
.
MTN
.
Asset
-Back ed
Secur ities
.
Real
Est ate
Inves tment
Fund s in the form of colle ctive inves tment contr acts . Infra stru ture Inves tment Fund s in the form of colle ctive inves tment contr acts . Contr act of Option and Contr act of Deriv ative Secur ities Listed on Stoc k Exch ange in Indon esia . REPO . Direc
Part
icip ation
.
Land in
Indon esia
.
Build ings in
Indon esia
.
Land and

Build ings in
Indon esia
3. Considerations Underlying the Investment Plan
.........................................................................................................................................
.........................................................................................................................................
......................................
(Filled with considerations or assumptions used by Management as the basis for determining the investment plan in accordance with POJK on Pension Fund Investments.)

Format 8: Funding Plan
Funding Plans for Partnered Pension Funds need to be detailed down to each partner. (Funding plans generally coming from contributions or their development results. Contributions can be made by the employer alone or jointly between the employer and workers (participants)).

Plan to Fulfill Funding Ratio

Table Plan to Fulfill Funding Ratio (Specific to DB Programs)
Description
Actual
Per 30 Sept
20XX-1
Projection
Per 31 Dec
20XX-1
Per 30 Jun
20XX
Per 31 Dec
20XX
Funding Wealth
Actuarial Present Value
Solvency Liability
Surplus / Deficit
Funding Ratio (%)
Solvency Ratio (%)
Funding Quality*
Note:
X-1: year of report preparation.
X: year of business plan position.

The term Funding Quality refers to Funding Quality as per POJK 8/POJK.05/2018 Article 2 paragraph (1) which includes the following conditions:

(a). first level, namely if the Employer Pension Fund implementing a DB Program is in a Fully Funded state; (b). second level, namely if Funding Wealth is less than Actuarial Present Value and not less than Solvency Liability; and (c). third level, namely if Funding Wealth is less than Solvency Liability.
2) Reasons and Considerations *
..........................................................................................................................
..........................................................................................................................
.................

Filled with reasons/considerations in preparing the plan to fulfill the Funding Ratio.

Strategy *
..........................................................................................................................
..........................................................................................................................
.................

Filled with strategies to realize the plan to fulfill the Funding Ratio.

Funding Projection
Description
Actual
Per 30 Sept
20XX-1
Projection
Per 31 Dec
20XX-1
Per 30 Jun
20XX
Per 31 Dec
20XX
Participant Normal Contribution
Participant Voluntary Contribution
Employer Normal
Contribution
Additional Contributions
Employer
Total Contribution Funds
Note:
X-1: year of report preparation.
X: year of business plan position.

Format 9: Office Network and/or Distribution Channel Development and/or Change Plan (Office network and/or distribution channel development and/or change plans must at least include plans for opening and merging offices outside the head office.) Note:
¹ Filled with the month of the planned implementation time. ² For locations in the DKI Jakarta region, at least mention the province name DKI Jakarta. For locations outside the DKI Jakarta region, at least mention the Regency/City name. ³ Detailed notes can be attached on a separate sheet.

Format 10: Organizational, Human Resources, and/or Information Technology Development Plan

Organizational Development Plan

Description Regarding Organizational Development Plan*
..........................................................................................................................
..........................................................................................................................
.................

Filled with explanations regarding organizational development plans,
among others plans for the formation of work units/divisions, plans for changes

No Change in Office Network
Implementation Time 1
Location 2 Note 3
A. Opening
1.
2.
B. Merging
1.
2.
C. Address Change
1.
2.
Etc
D. Office Closure
1.
2.
Etc

work unit/division, and the plan for committee formation, adjusted according to the size and complexity of the Pension Fund's business.

Reasons and Considerations*
..........................................................................................................................
..........................................................................................................................
.................

Filled with reasons/considerations in compiling the organizational development plan.

Strategy*
..........................................................................................................................
..........................................................................................................................
.................

Filled with the strategy to realize the organizational development plan.

Human Resource Fulfillment Plan

Description Regarding the Human Resource Fulfillment Plan
No Level Position Number of HR per 30 Sept 20XX-1 Semester II 20XX-1 Semester I 20XX Semester II 20XX (+)* (-)* (+) (-) (+) (-) 1. 2. Etc. Total

Filled with the increase and decrease in the number of employees.

Reasons and Considerations*
..........................................................................................................................
..........................................................................................................................
.................

Filled with reasons/considerations in compiling the human resource fulfillment plan.

Strategy*
..........................................................................................................................
..........................................................................................................................
.................

Filled with the strategy to realize the human resource fulfillment plan.

Plan for Implementing Education and Training for Management, Board of Commissioners, and Employees

Human Resource Development Plan Table
No Material/Topic Participant Name Position Certification Already Owned Training Time 1. 2. Etc.
Reasons and Considerations*
..........................................................................................................................
..........................................................................................................................
.................

Filled with reasons/considerations in compiling the human resource development plan.

Strategy*
..........................................................................................................................
..........................................................................................................................
.................

Filled with the strategy to realize the human resource development plan.

Plan for Utilization of Outsourced Labor

Outsourced Labor Utilization Plan Table
No Field of Work Reason for Outsourced Labor Utilization Number of Outsourced Workers Name of Outsourced Labor Provider Company (if any) Contract Period with Outsourced Labor Provider Company 1. 2. 3. ...
Reasons and Considerations*
..........................................................................................................................
..........................................................................................................................
.................

Filled with reasons/considerations in compiling the outsourced labor utilization plan.

Strategy*
..........................................................................................................................
..........................................................................................................................
.................

Filled with the strategy to realize the outsourced labor utilization plan.

Information Technology System Development Plan

Information Technology System Utilization Plan Table
No Type/Name of Application Ownership (In-house/vendor) Vendor Name Application Function 1. 2.
..........................................................................................................................
..........................................................................................................................
.................

Filled with the plan for fundamental information technology development and procurement, including: significant changes to information technology configuration or core applications, procurement of new core applications, cooperation with information technology service providers, and/or other fundamental information technology development and procurement that can add and/or increase the Pension Fund's risk. Additionally, information regarding the cost of information technology development and maintenance must be filled in.

Reasons and Considerations*
..........................................................................................................................
..........................................................................................................................
.................

Filled with reasons/considerations in compiling the fundamental information technology development and procurement plan.

Strategy*
..........................................................................................................................
..........................................................................................................................
.................

Filled with the strategy to realize the fundamental information technology development and procurement plan.

Format 11: Financial Statement Projections

Net Asset Statement Projection for Pension Funds
(in full rupiah units)
DESCRIPTION Actual as of 30 Sep 20XX-1 Projection as of 31 December 20XX-1 As of 30 Jun 20XX As of 31 Dec 20XX ASSETS INVESTMENTS Bank Savings On-call Deposits at Banks Time Deposits at Banks Bank Certificates of Deposit Securities issued by Bank Indonesia Government Securities Stocks listed on the Indonesia Stock Exchange Corporate Bonds listed on the Indonesia Stock Exchange Corporate Sukuk listed on the Indonesia Stock Exchange Regional Bonds/Sukuk Mutual Funds MTN Asset-Backed Securities Real Estate Investment Funds in the form of collective investment contracts Infrastructure Investment Funds

DESCRIPTION Actual as of 30 Sep 20XX-1 Projection as of 31 December 20XX-1 As of 30 Jun 20XX As of 31 Dec 20XX in the form of collective investment contracts Options contracts and forward contracts for securities listed on the Indonesia Stock Exchange REPO Direct Participation Land in Indonesia Buildings in Indonesia Land and Buildings in Indonesia TOTAL INVESTMENTS CURRENT ASSETS OUTSIDE INVESTMENTS Cash and Bank Contribution Receivables

Normal Contributions from Employers
Normal Contributions from Participants
Voluntary Contributions from Participants
Additional Contributions
Interest Receivables
Late Contribution Fees
Prepaid Expenses
Investment Receivables
Investment Income Receivables
Other Receivables
TOTAL CURRENT ASSETS OUTSIDE INVESTMENTS OPERATIONAL ASSETS Land and Buildings Vehicles Computer Equipment Office Equipment

DESCRIPTION Actual as of 30 Sep 20XX-1 Projection as of 31 December 20XX-1 As of 30 Jun 20XX As of 31 Dec 20XX Other Operational Assets TOTAL OPERATIONAL ASSETS OTHER ASSETS AVAILABLE ASSETS LIABILITIES Liabilities Outside Actuarial Present Value (PPMP) Liabilities Outside Pension Benefit Liabilities (PPIP) Pension Benefit and Other Benefit Payables Due Voluntary Benefit Payables Investment Payables Unearned Revenue Expenses Payable Other Payables Total Liabilities Outside Actuarial Present Value/Pension Benefit Liabilities TOTAL LIABILITIES NET ASSETS Notes:

If the business plan submission is for the year 2020, then 20XX-1 is the year 2019 (current year), 20XX is the year 2020, etc.
The Net Asset nominal is equal to the Net Asset Nominal at the End of the Period in the Projection of the Statement of Changes in Net Assets.

Projection of Statement of Changes in Net Assets
(in full rupiah units)
Description Actual as of 30 Sept 20XX-1 Projection as of 31 Dec 20XX-1 As of 30 Jun 20XX As of 31 Dec 20XX ADDITIONS Investment Income

Description Actual as of 30 Sept 20XX-1 Projection as of 31 Dec 20XX-1 As of 30 Jun 20XX As of 31 Dec 20XX Interest/Profit Sharing Dividends Rent Profit (Loss) from Investment Disposal Other Investment Income Total Investment Income Increase (Decrease) in Investment Value Due Contributions:

Normal Contributions from Employers
Normal Contributions from Participants
Voluntary Contributions from Participants
Additional Contributions
Income Outside Investment
Transfer of Funds from Other Pension Funds Total Additions REDUCTIONS Investment Expenses Operational Expenses Expenses Outside Investment and Operations Pension Benefits and Other Benefits Income Tax Transfer of Funds to Other Pension Funds Total Reductions INCREASE (DECREASE) IN NET ASSETS NET ASSETS AT BEGINNING OF PERIOD NET ASSETS AT END OF PERIOD Notes:

If the business plan submission is for the year 2020, then 20XX-1 is the year 2019 (current year), 20XX is the year 2020, etc.
The Net Asset Nominal at the End of the Period is equal to the Net Assets in the Projection of the Net Asset Statement.

Format 12: Projection of Ratios and Other Specific Items, and Assumptions Used

Ratios and Other Specific Items
(ratios in percentage)
DESCRIPTION Actual as of 30 Sept 20XX-1 Projection as of 31 Dec 20XX-1 As of 30 Jun 20XX As of 31 Dec 20XX Investment Income Ratio (ROI) Investment Income to Assets Ratio (ROA) Operational Expense Ratio (BOPO) Contribution Receivable Age Ratio (KRCA) Funding Ratio (RKD) specifically for PPMP Solvency Ratio specifically for PPMP Notes:

If the business plan submission is for the year 2020, then 20XX-1 is the year 2019 (current year), 20XX is the year 2020, etc.

Assumptions Used
No. DESCRIPTION Actual as of 30 Sept 20XX Projection as of 31 Dec 20XX As of 30 Jun 20XX+1 As of 31 Dec 20XX+1
Actuarial Interest Rate Assumption (specifically for PPMP) (%)

Notes:

If the business plan submission is for the year 2020, then 20XX-1 is the year 2019 (current year), 20XX is the year 2020, etc.

Format 13: Other Information
Other information must at least include information that needs to be submitted because it affects the Pension Fund's business activities, which are not mentioned in the scope of the Business Plan. Examples:
a. dissolution plan; b. dissolution plan of founding partners;
c. transfer of membership plan;
d. plan to change business activities from non-Sharia principles to Sharia principles; and e. Sustainable Finance Action Plan based on POJK regarding the Implementation of Sustainable Finance for Financial Service Institutions, Issuers, and Public Companies.

Actuarial Calculation Method Assumptions
Mortality Rate Assumptions
Target Investment Return Rate in Investment Directives (%)
Etc. (other relevant assumptions)

F. Pension Fund Business Plan Realization Report The Business Plan Realization Report is in accordance with Article 14 paragraph (5) of POJK Number 24/POJK.05/2019 concerning Business Plans of Non-Bank Financial Service Institutions, with a submission deadline of at most 1 (one) month after the relevant semester ends.

BUSINESS PLAN REALIZATION REPORT
Year ...............................
(filled with Pension Fund name and address) Approved, Board of Commissioners (Pension Fund Stamp) Clear Name Position , 20xx Management, (Pension Fund Stamp) Clear Name Position

Explanation Regarding Business Plan Achievement
Filled with an explanation regarding the achievement of the Business Plan, including the achievement of the Business Plan and a comparison of the plan and its realization, which must at least include:
realization of business activities as referred to in Format 5 in the Pension Fund business plan;
realization of business plan development or expansion as referred to in Format 6 in the Pension Fund business plan;
realization of investment plans as referred to in Format 7 in the Pension Fund business plan;
realization of funding plans as referred to in Format 8 in the Pension Fund business plan;
realization of office network or distribution channel development and/or changes as referred to in Format 9 in the Pension Fund business plan;
realization of organizational, human resource, and/or information technology development as referred to in Format 10 in the Pension Fund business plan;
realization of financial statement projections, as referred to in Format 11 in the Pension Fund business plan;
realization of ratio projections and other specific items, and assumptions used, as referred to in Format 12 in the Pension Fund business plan; and
filling of the business plan based on the business plan report last submitted to the OJK.
Explanation Regarding Deviations from Business Plan Realization

Net Asset Statement Realization for Pension Funds
(in full rupiah units)
DESCRIPTION Business Plan (1) Realization (2) Achievement % (2)/(1) ASSETS INVESTMENTS Bank Savings On-call Deposits at Banks Time Deposits at Banks Bank Certificates of Deposit Securities issued by Bank Indonesia

(in full rupiah units)
DESCRIPTION Business Plan (1) Realization (2) Achievement % (2)/(1) Government Securities Stocks listed on the Indonesia Stock Exchange Corporate Bonds listed on the Indonesia Stock Exchange Corporate Sukuk listed on the Indonesia Stock Exchange Regional Bonds/Sukuk Mutual Funds MTN Asset-Backed Securities Real Estate Investment Funds in the form of collective investment contracts Infrastructure Investment Funds in the form of collective investment contracts Options contracts and forward contracts for securities listed on the Indonesia Stock Exchange REPO Direct Participation Land in Indonesia Buildings in Indonesia Land and Buildings in Indonesia TOTAL INVESTMENTS CURRENT ASSETS OUTSIDE INVESTMENTS Cash and Bank Contribution Receivables

Normal Contributions from Employers

(in full rupiah units)
DESCRIPTION Business Plan (1) Realization (2) Achievement % (2)/(1)

Normal Contributions from Participants
Voluntary Contributions from Participants
Additional Contributions
Interest Receivables
Late Contribution Fees
Prepaid Expenses
Investment Receivables
Investment Income Receivables
Other Receivables
TOTAL CURRENT ASSETS OUTSIDE INVESTMENTS OPERATIONAL ASSETS Land and Buildings Vehicles Computer Equipment Office Equipment Other Operational Assets TOTAL OPERATIONAL ASSETS OTHER ASSETS AVAILABLE ASSETS LIABILITIES Liabilities Outside Actuarial Present Value (PPMP) Liabilities Outside Pension Benefit Liabilities (PPIP) Pension Benefit and Other Benefit Payables Due Voluntary Benefit Payables Investment Payables Unearned Revenue

(in full rupiah units)
DESCRIPTION Business Plan (1) Realization (2) Achievement % (2)/(1) Expenses Payable Other Payables Total Liabilities Outside Actuarial Present Value/Pension Benefit Liabilities TOTAL LIABILITIES NET ASSETS

Statement of Changes in Net Assets Realization
(in full rupiah units)
DESCRIPTION Business Plan (1) Realization (2) Achievement % (2)/(1) ADDITIONS Investment Income Interest/Profit Sharing Dividends Rent Profit (Loss) from Investment Disposal Other Investment Income Total Investment Income Increase (Decrease) in Investment Value Due Contributions:

Normal Contributions from Employers
Normal Contributions from Participants

(in full rupiah units)
DESCRIPTION Business Plan (1) Realization (2) Achievement % (2)/(1)

Voluntary Contributions from Participants
Additional Contributions
Income Outside Investment
Transfer of Funds from Other Pension Funds Total Additions REDUCTIONS Investment Expenses Operational Expenses Expenses Outside Investment and Operations Pension Benefits and Other Benefits Income Tax Transfer of Funds to Other Pension Funds Total Reductions INCREASE (DECREASE) IN NET ASSETS NET ASSETS AT BEGINNING OF PERIOD NET ASSETS AT END OF PERIOD

Realization of Assumptions Used
No. DESCRIPTION Business Plan (1) Realization (2) Deviation (2)-(1)

Actuarial Interest Rate Assumption (specifically for PPMP) (%)
Actuarial Calculation Method Assumptions
Mortality Rate Assumptions

Realization of Ratios and Other Specific Items
DESCRIPTION Business Plan (1) Realization (2) Achievement % (2)/(1) Investment Income Ratio (ROI) Investment Income to Assets Ratio (ROA) Operational Expense Ratio (BOPO) Funding Ratio (Specifically for PPMP) Solvency Ratio (Specifically for PPMP)

Other Information
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
........................................................

Filled with an explanation regarding the achievement of other information in the Business Plan and a comparison of the plan and its realization.

Follow-up on Business Plan Achievement
................................................................................................................................
................................................................................................................................
..........................
Target Investment Return Rate in Investment Directives (%)
Etc. (other relevant assumptions)

G. Business Plan Supervision Report
The Business Plan Supervision Report is in accordance with Article 15 paragraph (1) of POJK Number 24/POJK.05/2019 concerning Business Plans of Non-Bank Financial Service Institutions, with a submission deadline of at most 1 (one) month after the relevant semester ends.

BUSINESS PLAN SUPERVISION REPORT
Year ...............................
(filled with Pension Fund name and address) , 20xx Board of Commissioners (Pension Fund Stamp) Clear Name Position

Established in Jakarta on January 21, 2021 EXECUTIVE HEAD OF SUPERVISOR OF INSURANCE, PENSION FUNDS, LENDING INSTITUTIONS, AND OTHER FINANCIAL SERVICE INSTITUTIONS FINANCIAL SERVICES AUTHORITY REPUBLIC OF INDONESIA, signature RISWINANDI
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
.................
(filled with the Board of Commissioners' assessment of the implementation of the Business Plan, including quantitative and qualitative assessment of the Business Plan realization, including assessment of good corporate governance factors for the Pension Fund, risk profile, profitability, and funding, as well as efforts to improve the Pension Fund's performance, if according to the assessment there is a decline in the Pension Fund's performance). This copy is in accordance with the original Legal Director 1 Legal Department signature Mufli Asmawidjaja

APPENDIX II
CIRCULAR LETTER OF THE FINANCIAL SERVICES AUTHORITY REPUBLIC OF INDONESIA NUMBER 4 /SEOJK.05/2021 CONCERNING THE FORM AND STRUCTURE OF PERIODIC REPORTS FOR PENSION FUNDS

FORMAT II A
To
The Director of Pension Fund and BPJS Ketenagakerjaan Supervision Financial Services Authority MONTHLY REPORT / ELECTRONIC DATA FINANCIAL INSTITUTION PENSION FUNDS As of DD-MM-YYYY

General Data
Reporting Date
Pension Fund Code
Pension Fund Name
Reporting Period
Reporting Month
Fiscal Year
Type of Reporting Period Annual Report/Monthly Report Management Name Management Position SID Number Audit Data Auditor License Number Audit Type Auditor Code Auditor Name Opinion Audit Executor Audit Date Report Compiler Officer Name Division Telephone Fax E-mail Person in Charge of Acting Management Person in Charge Name Position Telephone Fax E-mail Pension Fund Address

Description Details Code Percentage
Investment
Other Benefit Program
Combined
ASSETS
INVESTMENTS
Bank Savings 1101
On-call Deposits at Banks 1102
Time Deposits at Banks 1103
Bank Certificates of Deposit 1104
Securities issued by Bank Indonesia 1105 Government Securities 1106 Stocks listed on the Indonesia Stock Exchange 1107 Corporate Bonds listed on the Indonesia Stock Exchange 1108 Corporate Sukuk listed on the Indonesia Stock Exchange 1109 Regional Bonds/Sukuk 1110 Mutual Funds 1111 MTN 1112 Asset-Backed Securities 1113 Real Estate Investment Funds in the form of collective investment contracts 1114 Infrastructure Investment Funds in the form of collective investment contracts 1115 Options contracts and forward contracts for securities listed on the Indonesia Stock Exchange 1116 REPO 1117 Direct Participation 1118 Land in Indonesia Buildings in Indonesia Land and Buildings in Indonesia TOTAL INVESTMENTS CURRENT ASSETS OUTSIDE INVESTMENTS Cash and Bank 1201 Prepaid Expenses 1204 Investment Receivables 1205 Investment Income Receivables 1206 Other Receivables 1207 TOTAL CURRENT ASSETS OUTSIDE INVESTMENTS AVAILABLE ASSETS LIABILITIES Liabilities Outside Pension Benefit Liabilities Pension Benefit and Other Benefit Payables Due 1501 Voluntary Benefit Payables 1502 Investment Payables 1503 Unearned Revenue 1504 Expenses Payable 1505 Other Payables 1506 TOTAL LIABILITIES OUTSIDE PENSION BENEFIT LIABILITIES NET ASSETS DEFINED BENEFIT PENSION PROGRAM NET ASSET STATEMENT As of DD-MM-YYYY

Other Benefit Program
Combined
ADDITIONS
Investment Income
Interest/Profit Sharing
Dividends
Rent
Profit (Loss) from Investment Disposal Other Investment Income Total Investment Income Increase (Decrease) in Investment Value 401 Contributions 402 Income Outside Investment 403 Transfer of Funds from Other Pension Funds 404 Total Additions REDUCTIONS Investment Expenses 405 Operational Expenses 406 Expenses Outside Investment and Operations 407 Pension Benefits and Other Benefits Income Tax 408 Transfer of Funds to Other Pension Funds 409 Contribution Withdrawals Total Reductions INCREASE (DECREASE) IN NET ASSETS NET ASSETS AT BEGINNING OF PERIOD NET ASSETS AT END OF PERIOD DEFINED BENEFIT PENSION PROGRAM STATEMENT OF CHANGES IN NET ASSETS Accumulated as of DD-MM-YYYY Description Details Code Accumulated as of DD-MM-YYYY

ASSETS

INVESTMENTS (Historical Value)

Bank Savings
On-call Deposits at Banks
Time Deposits at Banks
Bank Certificates of Deposit
Securities issued by Bank Indonesia
Government Securities
Stocks listed on the Indonesia Stock Exchange Corporate Bonds listed on the Indonesia Stock Exchange Corporate Sukuk listed on the Indonesia Stock Exchange Regional Bonds/Sukuk Mutual Funds MTN Asset-Backed Securities Real Estate Investment Funds in the form of Collective Investment Contracts Infrastructure Investment Funds in the form of Collective Investment Contracts Options contracts and futures contracts for securities listed on the Indonesia Stock Exchange REPO Direct Participation Land in Indonesia Buildings in Indonesia Land and Buildings in Indonesia Accumulated Depreciation of Buildings TOTAL INVESTMENTS

INVESTMENT VALUATION DIFFERENCE

CURRENT ASSETS EXCLUDING INVESTMENTS

Cash and Bank
Prepaid Expenses
Investment Receivables
Investment Income Receivables
Other Receivables

TOTAL CURRENT ASSETS EXCLUDING INVESTMENTS

TOTAL ASSETS

LIABILITIES

PENSION BENEFIT LIABILITIES

Accumulated Contributions
Operating Results
Transfer of Funds from Other Pension Funds

TOTAL PENSION BENEFIT LIABILITIES

LIABILITIES EXCLUDING PENSION BENEFIT LIABILITIES

Due Pension Benefits and Other Benefits Due Voluntary Benefit Payables Investment Payables Unearned Revenue Expenses Incurred but Not Yet Paid Other Payables

TOTAL LIABILITIES EXCLUDING PENSION BENEFIT LIABILITIES

TOTAL LIABILITIES

DEFINED CONTRIBUTION PENSION PROGRAM

BALANCE SHEET

As of DD-MM-YYYY
Description

Other Benefit Pension Program

INVESTMENT INCOME

Interest/Profit Sharing
Dividends
Rent
Profit (Loss) on Investment Disposal
Other Investment Income
Total Investment Income

INVESTMENT EXPENSES

Transaction Expenses
Land and Building Maintenance Expenses Building Depreciation Expenses Investment Manager Fees Custodian Fees Other Investment Expenses Total Investment Expenses

INVESTMENT RESULTS

OPERATIONAL EXPENSES

Fees to Founders
Total Operational Expenses

OTHER INCOME AND EXPENSES

Other Income Excluding Investment
Other Expenses Excluding Investment and Operational Total Other Income and Expenses

PRE-TAX OPERATING RESULTS

INCOME TAX

AFTER-TAX OPERATING RESULTS

DEFINED CONTRIBUTION PENSION PROGRAM

STATEMENT OF COMPREHENSIVE INCOME

Accumulated as of DD-MM-YYYY
Description

Other Benefit Pension Program

CASH FLOWS FROM INVESTMENT ACTIVITIES

Interest/Profit Sharing Receipts
Dividend Receipts
Rent Receipts
Other Investment Income
Investment Disposal
Investment Placement
Payment of Investment Expenses
Net Cash Flows from Investment Activities

CASH FLOWS FROM OPERATIONAL ACTIVITIES

Payment of Operational Expenses
Income Excluding Investment
Other Expenses Excluding Investment and Operational Income Tax Net Cash Flows from Operational Activities

CASH FLOWS FROM FINANCING ACTIVITIES

Contribution Receipts
Receipts of Fund Transfers from Other Pension Funds Payment of Fund Transfers to Other Pension Funds Payment of Pension Benefits and Other Benefits Contribution Withdrawals Net Cash Flows from Financing Activities

INCREASE (DECREASE) IN NET CASH

CASH AT BEGINNING OF PERIOD

CASH AT END OF PERIOD

DEFINED CONTRIBUTION PENSION PROGRAM

STATEMENT OF CASH FLOWS

Accumulated as of DD-MM-YYYY
Description

PENSION FUND PARTICIPATION

As of DD-MM-YYYY
Description

Other Benefit Program

Total

(1) Active Participants a. Individuals b. Groups (2) Inactive Participants (Those Entitled to Deferred Pension Benefits) a. Individuals b. Groups (3) Total DPLK Participants (1) + (2) (4) Total number of all employers (companies) that include their employees in DPLK

INVESTMENT RECAPITULATION

As of DD-MM-YYYY

Jan	Feb	Mar	Apr	May	Jun	Jul	Aug	Sep	Oct	Nov	Dec
Uraian

Tabungan	Deposito Berjangka	Sertifikat Deposito	SBI	SBN	Life Cycle Fund
a	b	c	d	e	f	g

As of DD-MM-YYYY

Total Participants	Total Funds
Investment Assets

Interest/Profit Sharing	Dividends	Rent	Profit/Loss Disposal	Others
Bank Savings
On-call Deposits at Banks
Time Deposits at Banks
Bank Certificates of Deposit
Securities issued by Bank Indonesia
Government Securities
Stocks listed on the Indonesia Stock Exchange
Corporate Bonds listed on the Indonesia Stock Exchange
Corporate Sukuk listed on the Indonesia Stock Exchange
Regional Bonds/Sukuk
Mutual Funds
MTN
Asset-Backed Securities
Real Estate Investment Funds in the form of Collective Investment Contracts
Infrastructure Investment Funds in the form of Collective Investment Contracts
Options contracts and futures contracts for securities listed on the Indonesia Stock Exchange
REPO
Direct Participation
Land in Indonesia
Buildings in Indonesia
Land and Buildings in Indonesia
Total

Note:
The Unrealized Investment Income column uses data according to the Investment Value Increase/Decrease account on the LPAN sheet.

DEFINED CONTRIBUTION PENSION PROGRAM

INVESTMENT INCOME STATEMENT

As of DD-MM-YYYY

Investment Type	Realized Investment Income	Unrealized Investment Income	Investment Expenses	Net Investment Income	Average Investment	ROI
Interest/Profit Sharing
Dividends
Rent
Profit/Loss Disposal
Others
Bank Savings
On-call Deposits at Banks
Time Deposits at Banks
Bank Certificates of Deposit
Securities issued by Bank Indonesia
Government Securities
Stocks listed on the Indonesia Stock Exchange
Corporate Bonds listed on the Indonesia Stock Exchange
Corporate Sukuk listed on the Indonesia Stock Exchange
Regional Bonds/Sukuk
Mutual Funds
MTN
Asset-Backed Securities
Real Estate Investment Funds in the form of Collective Investment Contracts
Infrastructure Investment Funds in the form of Collective Investment Contracts
Options contracts and futures contracts for securities listed on the Indonesia Stock Exchange
REPO
Direct Participation
Land in Indonesia
Buildings in Indonesia
Land and Buildings in Indonesia
Total

Note:
The Unrealized Investment Income column uses data according to the Investment Value Increase/Decrease account on the LPAN sheet.

DEFINED CONTRIBUTION PENSION PROGRAM

OTHER BENEFIT INVESTMENT INCOME STATEMENT

As of DD-MM-YYYY

Investment Type	Realized Investment Income	Unrealized Investment Income	Investment Expenses	Net Investment Income	Average Investment	ROI
Interest/Profit Sharing	Rupiah	Non-Rupiah	Total	Rupiah	Non-Rupiah	Total	Rupiah	Non-Rupiah	Total	Rupiah	Non-Rupiah	Total	Rupiah	Non-Rupiah	Total
Bank Savings
On-call Deposits at Banks
Time Deposits at Banks
Bank Certificates of Deposit
Securities issued by Bank Indonesia
Government Securities
Stocks listed on the Indonesia Stock Exchange
Corporate Bonds listed on the Indonesia Stock Exchange
Corporate Sukuk listed on the Indonesia Stock Exchange
Regional Bonds/Sukuk
Mutual Funds
MTN
Asset-Backed Securities
Real Estate Investment Funds in the form of Collective Investment Contracts
Infrastructure Investment Funds in the form of Collective Investment Contracts
Options contracts and futures contracts for securities listed on the Indonesia Stock Exchange
REPO
Direct Participation
Land in Indonesia
Buildings in Indonesia
Land and Buildings in Indonesia
Total Investments
B. Current Assets Excluding Investments
Cash and Bank
Prepaid Expenses
Investment Receivables
Investment Income Receivables
Other Receivables
Total Current Assets Excluding Investments
C. Total Assets (A+B)
D. Pension Benefit Liabilities
Accumulated Contributions
Operating Results
Transfer of Funds from Other Pension Funds
TOTAL PENSION BENEFIT LIABILITIES
E. Liabilities Excluding Pension Benefit Liabilities
Due Pension Benefits and Other Benefits Due
Voluntary Benefit Payables
Investment Payables
Unearned Revenue
Expenses Incurred but Not Yet Paid
Other Payables
Total Liabilities Excluding Pension Benefit Liabilities
F. Total Liabilities (D+E)
G. Difference between Total Assets and Total Liabilities (C-F)
H. Percentage (%) Fund Sufficiency Ratio

DEFINED CONTRIBUTION PENSION PROGRAM

ASSET AND LIABILITY RECAPITULATION

As of DD-MM-YYYY
(in Rupiah)

Description	Maturity < 1 year	1 year <= Maturity < 5 years	5 years <= Maturity < 10 years	Maturity >= 10 Years	Total
Type	Amount	Percentage of Total Investment
a	b	c	d	e	f	g
…

Investment Details with a Single Counterparty

No	Counterparty Name	Investment Type	Amount	Percentage of Total Investment

Investment Limits in Directives

Investment Type	Amount	Percentage of Total Investment
a	b	c	d	e	f	g
…

Investment Limits According to Regulations

Investment Type	Amount	Percentage of Total Investment
a	b	c	d	e	f	g
…

Investment Details with Affiliated Parties

As of DD-MM-YYYY

No	Counterparty Name	Investment Type	Affiliation Relationship	Description

Investment Type | Amount | Percentage of Total Investment

---	---	---
a	b	c	d	e	f	g
…

Note: a. Stocks with issuers indicated to be bankrupt b. Mutual Funds indicated to be traded abnormally Identified problematic investments can be obtained from the investment balances with identified problematic parties from the Pension Fund Financial Statements. Information on investees experiencing problems (default risk) can be obtained among others from investee financial statements, media disclosures, and/or from rating agencies. Examples:
c. Bond issuers or deposit-issuing banks recording losses.
d. There is a downgrade of bond instrument ratings below investment grade. e. There is a delay in coupon payments for Bonds or interest for Deposits. f. Bond issuers or deposit issuers involved in legal cases or indicated fraud. g. Restructured bonds h. Ownership of Land and/or Buildings not yet in the name of the Pension Fund

Details of Identified Problematic Investments

As of DD-MM-YYYY

No	Counterparty Name	Investment Type	Problematic Category	Description

Investment Income Ratio (ROI)

A. Total Investment Income – Investment Expenses B. Average Investment
C. Ratio (A:B)

Investment Income to Assets Ratio (ROA)

A. (Total Investment Income + Income Excluding Investment) - (Investment Expenses + Operational Expenses + Expenses Excluding Investment and Operational) B. Average Available Assets
C. Ratio (A:B)

Operational Expense Ratio (BOPO)

A. Operational Expenses
B. Investment Income + Income Excluding Investment
C. Ratio (A:B)

Contribution Receivable Age Ratio (RUPI)

A. Contribution Receivables (LAN) x Number of Current Months B. Due Contributions (LPAN)
C. Ratio (A:B)

Investment to Net Assets Ratio (RITA)

A. Total Investments x 100%
B. Total Net Assets
C. Ratio (A:B)

Investment Receivables and Investment Income Receivables to Total Investments

A. Investment Receivables + Investment Income Receivables B. Total Investments
C. Ratio (A:B)

Investment Growth Ratio

A. (Total Investments t1 - Total Investments t0) x 100% B. Total Investments t0
C. Ratio (A:B)

Market Price Changes in Pension Fund Assets

A. (SPI_n - SPI_n-1) x 100%
B. SPI_n-1
C. Ratio (A:B)

SPI compared to Total Income

A. SPI
B. Total Income
C. Ratio (A:B)

SPI compared to Net Assets

A. SPI
B. Net Assets
C. Ratio (A:B)

Minimum Liquidity Ratio / Cash Ratio

A. Current Assets or Investments for minimum liquidity fulfillment B. Operational Costs + Investment Costs + Pension Benefits and Other Benefits Due (one year)
C. Ratio (A:B)

Cash Inflows compared to Cash Outflows

A. Cash Inflows from Investment, Operational, and Financing Activities B. Cash Outflows from Investment, Operational, and Financing Activities
C. Ratio (A:B)

Contribution Receivable Ratio to Net Assets

A. Contribution Receivables
B. Net Assets
C. Ratio (A:B)

Growth Ratio of Founder Contribution Receivables (Employer Contributions + Additional Contributions)

A. (Total Founder Contribution Receivables t1 - Total Founder Contribution Receivables t0) X 100% B. Total Founder Contribution Receivables t0
C. Ratio (A:B)

Ratio of Total Long-Term Assets to Total Long-Term Liabilities

A. Total Long-Term Assets x 100%
B. Total Long-Term Liabilities
C. Ratio (A:B)

Income to Expenditure Ratio

A. Operational Expenses + Investment Expenses + Payment of Pension Benefits B. Total Income
C. Ratio (A:B)

Interest Rate Spread

A. Investment Income Ratio (ROI)
B. Actuarial Interest Rate
C. Ratio (A-B)

Ratio of Current Assets to Total Assets

A. Current Assets
B. Total Assets
C. Ratio (A:B)

Ratio of Current Liabilities to Total Liabilities

A. Current Liabilities
B. Total Liabilities
C. Ratio (A:B)

Operating Expense Ratio

A. Operational Expenses + Investment Expenses B. Investment Income
C. Ratio (A:B)

FINANCIAL RATIOS

As of DD-MM-YYYY

Description	Other Benefit Pension Program	Total	Notes
1) Comparison between long-term assets and long-term liabilities is obtained from the Pension Fund Financial Statements
2) Assets with a life > 1 year according to information as stated in the Pension Fund Financial Statements
3) Liabilities with a life > 1 year according to information as stated in the Pension Fund Financial Statements
1) Current assets are assets with a maturity of less than 1 year (excluding operational assets and other assets) as presented in the Pension Fund Financial Statements.
2) Total assets are available assets as presented in the Pension Fund Financial Statements
1) Current liabilities are liabilities with a maturity of less than 1 year as presented in the Pension Fund Financial Statements.
2) Total Liabilities is the Actuarial Present Value for DC Programs and Pension Benefit Liabilities for DB Programs.
1) Operational expenses are as presented in the Statement of Changes in Net Assets
2) Investment expenses are as presented in the Statement of Changes in Net Assets
3) Investment income includes realized and unrealized investment income as presented in the Statement of Changes in Net Assets.
1) Total Investment Income is as presented in the Statement of Changes in Net Assets.
2) Investment Expenses are as presented in the Statement of Changes in Net Assets.
3) For the calculation of average investment, use the average investment assets throughout the year.
1) Total Investment Income is Income that is already realized and unrealized. Total Investment Income is as presented in the Statement of Changes in Net Assets.
2) Income Excluding Investment is as presented in the Statement of Changes in Net Assets.
3) Investments are as presented in the Net Assets Statement.
4) For the calculation of operational expenses, Operational Expenses are as presented in the Statement of Changes in Net Assets.
5) For the calculation of total available assets, use the average assets throughout the year. Total Available Assets is as presented in the Net Assets Statement.
1) Operational expenses as stated in the statement of changes in net assets
2) Investment Income is realized income as stated in the statement of changes in net assets
3) Income Excluding Investment as stated in the statement of changes in net assets
1) SPI is Investment Valuation Difference for instruments exposed to market risk that are actively traded. Example: investments in the capital market and deposits denominated in foreign currency
2) Total Income is total realized and unrealized income on the statement of changes in net assets
1) SPI is Investment Valuation Difference for instruments exposed to market risk that are actively traded. Example: investments in the capital market and deposits denominated in foreign currency
2) Total Income is total realized and unrealized income on the statement of changes in net assets
1) Cash Flows from investment activities are all investment activities except placement and disposal of investments as presented in the financial statements.
2) Cash Flows from operational activities are all operational activities except placement and disposal of operational assets and other assets as presented in the financial statements.
3) Cash Flows from financing activities are as presented in the financial statements.

Package A Package B Package C Package D etc.

Assets

Net Assets

Investments

a. Bank Savings b. On-call Deposits at Banks
c. Time Deposits at Banks
d. Bank Certificates of Deposit e. Securities issued by Bank Indonesia f. Government Securities g. Stocks listed on the Indonesia Stock Exchange h. Corporate Bonds listed on the Indonesia Stock Exchange
i. Corporate Sukuk listed on the Indonesia Stock Exchange
j. Regional Bonds/Sukuk k. Mutual Funds
l. MTN
m. Asset-Backed Securities n. Real Estate Investment Funds in the form of Collective Investment Contracts o. Infrastructure Investment Funds in the form of Collective Investment Contracts p. Options contracts and futures contracts for securities listed on the Indonesia Stock Exchange q. REPO r. Direct Participation s. Land in Indonesia t. Buildings in Indonesia u. Land and Buildings in Indonesia

Current Assets

a. Cash and Bank b. Prepaid Expenses
c. Investment Receivables
d. Investment Income Receivables e. Other Receivables

Liabilities Excluding Pension Benefit Obligations

a. Due Pension Benefits and Other Benefits Due b. Voluntary Benefit Payables
c. Investment Payables
d. Unearned Revenue e. Expenses Incurred but Not Yet Paid f. Other Payables

Investment Results

Increase (Decrease) in Investment Value

Number of Participants

Account Name

Conventional Package

Pension Fund

Investment Package Report

As of DD-MM-YYYY

(in millions of Rupiah)

Bill Number	Nominal	Maturity Date	Acquisition Value	Fair Value	Maturity Date
Total

PENSION FUNDS

PERIODIC PENSION BENEFIT INVESTMENT REPORT

Bank Name/Series Number	SBN	Deposits	SBN	Total
Total

Number of Participants MP	Periodic	Number of MP Lump Sum
Initial Reserve (20%)

Note:

No.	Investment Manager Name	Contract Number	Contract Date	Agreement Period	Investment Type

Total Fair Value of Funds Managed (Rp)	Acquisition Value (managed by Investment Manager)	Investment Valuation Difference	Return (%)	Net Investment Return (Rp)	Total Management Fees Charged (Rp)	Affiliated with Pension Fund (Yes/No)
1.
2.
3. dst

*: if using Investment Manager services

Investment Management Contract (KPD) Format by Investment Manager*

Pension Fund …..

Use of Investment Manager

As of DD-MM-YYYY

Total
etc.

Self-Management / KPD

Investment Manager Name
a	b	c	d	e	f	g	h	i	j	k
…
Total

Note:

SAVINGS DETAILS

No	Bank Name	Branch	Bank Code	Acquisition Date	Nominal Value

Interest Rate/Profit Sharing	Pension Program/Other Benefit
Management

Self-Management / KPD

Investment Manager Name
a	b	c	d	e	f	g	h	i	j	k
…
Total

Note:

ON-CALL DEPOSIT DETAILS

No	Bank Name	Acquisition Date	Nominal Value	Tenor

Interest Rate/Profit Sharing	Pension Program/Other Benefit
Management

Note:

TIME DEPOSIT DETAILS

No	Bank Name	Branch	Bank Code	Acquisition Date	Nominal Value	Tenor

Interest Rate/Profit Sharing	Pension Program/Other Benefit
Management

FOREIGN CURRENCY TIME DEPOSIT DETAILS

No	Bank Name	Branch	Bank Code	Acquisition Date	Nominal Value	Fair Value

Investment Valuation Difference	Tenor	Interest Rate/Profit Sharing	Pension Program/Other Benefit
Management

Note:

CERTIFICATE OF DEPOSIT DETAILS

No	Bank Name	Branch	Bank Code	Acquisition Date	Nominal Value	Tenor

Interest Rate/Profit Sharing	Pension Program/Other Benefit
Management

Note:

INDONESIAN SECURITIES DETAILS

No	Security Code	Acquisition Date	Nominal Value	Coupon (%)	Maturity Date

Acquisition Value	Fair Value	Investment Valuation Difference

Value %	Self-Management / KPD	Investment Manager Name
a	b	c	d	e	f	g	h	i	j	k	l	m	n
…
Total

Pension Program/Other Benefit	Recording Method	Description
Management

GOVERNMENT SECURITIES DETAILS

No	Security Code	Acquisition Date	Nominal Value	Coupon (%)	Maturity Date

Acquisition Value	Fair Value	Investment Valuation Difference

Value %	Self-Management / KPD	Investment Manager Name
a	b	c	d	e	f	g	h	i	j	k	l	m	n
…
Total

Pension Program/Other Benefit	Description
Management

STOCK DETAILS

No	Stock Code	Issuer/Issuer Name	Acquisition Date	Number of Shares	Acquisition Value	Market Value

Investment Valuation Difference	Economic Sector

Start	End	Value %	Self-Management / KPD	Investment Manager Name
a	b	c	d	e	f	g	h	i	j	k	l	m	n	o	p	q	r	s	t
…
Total

Investment Valuation Difference	Economic Sector	Pension Program/Other Benefit	Recording Method
Management

BOND DETAILS

No	Issuer Name	Bond Code	Bond Name	Acquisition Date	Nominal Value	Coupon (%)

Maturity Date	Rating	Description
Management

Acquisition Value	Fair Value

Start	End	Value %	Self-Management / KPD	Investment Manager Name
a	b	c	d	e	f	g	h	i	j	k	l	m	n	o	p	q	r	s	t
…
Total

Investment Valuation Difference	Economic Sector	Pension Program/Other Benefit	Recording Method
Management

CORPORATE SUKUK DETAILS

No	Issuer Name	Sukuk Code	Sukuk Name	Acquisition Date	Nominal Value	Coupon (%)

Maturity Date	Rating	Description
Management

Acquisition Value	Fair Value

Start	End	Value %	Self-Management / KPD	Investment Manager Name
a	b	c	d	e	f	g	h	i	j	k	l	m	n	o	p	q	r	s	t
…
Total

Investment Valuation Difference	Economic Sector	Pension Program/Other Benefit	Recording Method
Management

REGIONAL BOND/SUKUK DETAILS

No	Issuer Name	Regional Bond/Sukuk Code	Regional Bond/Sukuk Name	Acquisition Date	Nominal Value	Coupon (%)

Maturity Date	Rating	Description
Management

Acquisition Value	Fair Value

Value %	Self-Management / KPD	Investment Manager Name
a	b	c	d	e	f	g	h	i	j	k	l	m	n	o
…
Total

*) letter d:
Filled with Mutual Fund Type is Money Market Mutual Fund/Fixed Income Mutual Fund/Mixed Mutual Fund/Equity Mutual Fund/Protected Mutual Fund/Guaranteed Mutual Fund/Index Mutual Fund/Collective Investment Contract Limited Participation Mutual Fund/ and Mutual Fund whose Shares/Units are Traded on the Stock Exchange

MUTUAL FUND DETAILS

No	Code	Product Name	Mutual Fund Type *)	Investment Manager	Acquisition Date	Number of Units	Acquisition Value	Fair Value	Investment Valuation Difference	Pension Program/Other Benefit

Note:

Start	End	Value %	Self-Management / KPD	Investment Manager Name
a	b	c	d	e	f	g	h	i	j	k	l	m	n	o	p	q	r	s
…
Total

Fair Value	Investment Valuation Difference	Pension Program/Other Benefit	Description
Management

MTN DETAILS

No	Code	Product Name	Issuer Name	Acquisition Date	Nominal Value	Coupon (%)

Maturity Date	Rating	Economic Sector	Acquisition Value

Economic Sector	Start	End	Value %	Self-Management / KPD	Investment Manager Name
a	b	c	d	e	f	g	h	i	j	k	l	m	n	o	p	q	r	s
…
Total

ASSET-BACKED SECURITIES DETAILS

No	Code	Product Name	Issuer Name	Acquisition Date	Nominal Value	Coupon (%)

Maturity Date	Rating	Acquisition Value	Fair Value

Investment Valuation Difference	Pension Program/Other Benefit	Description
Management

Value %	Self-Management / KPD	Investment Manager Name
a	b	c	d	e	f	g	h	i	j	k	l	m	n
…
Total

Pension Program/Other Benefit	Description
Management

REAL ESTATE INVESTMENT FUNDS IN THE FORM OF COLLECTIVE INVESTMENT CONTRACTS DETAILS

No	Code	Product Name	Investment Manager	Acquisition Date	Number of Units	Acquisition Value	Fair Value

Investment Valuation Difference	Pension Program/Other Benefit	Description
Management

Percentage Value Self-Managed/ KPD Investment Manager Name a b c d e f g h i j k l m n … Total Pension Program/ Other Benefits Description DETAILS OF INFRASTRUCTURE INVESTMENT FUNDS IN THE FORM OF COLLECTIVE INVESTMENT CONTRACTS No. Code Product Name Investment Manager Acquisition Date Number of Units Acquisition Value Net Asset Value Investment Valuation Difference Percentage Value Self-Managed/ KPD Investment Manager Name a b c d e f g h i j k l m … Total Description Management DETAILS OF OPTIONS CONTRACTS AND STOCK FUTURES CONTRACTS RECORDED ON THE INDONESIAN STOCK EXCHANGE No. Issuer Name Buyer Name Acquisition Date Duration Acquisition Value Fair Value Investment Valuation Difference Pension Program/ Other Benefits

Beginning End Nominal % Value % Self-Managed/ KPD Investment Manager Name a b c d e f g h i j k l m n o p q r s t … Total Management DETAILS OF REPOS No. Counterparty Type of Collateral (SBN/SBI/OBL) Acquisition Date Collateral Value Rating Duration Category (KSEI/BIS4) Acquisition Value Margin Amortized Cost Sales Value Investment Valuation Difference Pension Program/ Other Benefits Description

Name Position Date % Ownership Total % Ownership Total Date % Ownership Total Value % a b c d e f g h i j k l m n o p q r … Total Self-Managed/ KPD Investment Manager Name Pension Fund Founders Founding Partners Board of Directors Custodians Labor Unions whose Members are DP Participants Other Founders Founding Partners Board of Directors Custodians Labor Unions whose Members are DP Participants Other s t u v w x y z a1 b1 c1 d1 e1 f1 g1 h1 i1 j1 k1 … Total ) letter e :
Filled with Domestic LJK/Non-Domestic LJK/Foreign LJK/Non-Foreign LJK Acquisition Value as of report date Appraisal/Fair Value Investment Valuation Difference Economic Sector Subsidiaries of Direct Participation (2) Total Paid-up Capital Subsidiaries of Direct Participation Ownership Percentage (e1) DETAILS OF DIRECT PARTICIPATIONS Management Description Total Paid-up Capital Ownership Percentage (v) No. No. Company Name (1) Pension Fund Representative Participation Category) Acquisition Date Pension Program/ Other Benefits Initial Placement

Object Type
(Land/Building/Land&Building)
Value %
Self-Managed/ KPD Investment Manager Name a b c d e f g h i j k l m n o p q r s t u … Total Management Book Value Appraisal/ Fair Value Appraisal Year Name Assessor Public/Independent Appraiser Name KJPP Investment Valuation Difference DETAILS OF LAND, BUILDINGS, OR LAND AND BUILDINGS IN INDONESIA No. Location Address (City,Province) Area Type Proof of Ownership Ownership Document Number Acquisition Date Acquisition Value Accumulated Depreciation Pension Program/ Other Benefits Description

No. Cash/Bank Name Branch Bank Code Account Number Nominal Pension Program/ Other Benefits Description (Purpose of use) a b c d e f g h … Total DETAILS OF CASH AND BANKS

No. Expense Type Amount
Pension Program/
Other Benefits
Description a b c d e
…
Total
DETAILS OF PREPAID EXPENSES

No. Investment Receivable Type Counterparty Nominal Pension Program/ Other Benefits Description a b c d e f … Total DETAILS OF INVESTMENT RECEIVABLES

No.
Investment Income
Receivable Type
Counterparty Nominal
Pension Program/
Other Benefits
Description a b c d e f
…
Total
DETAILS OF INVESTMENT INCOME RECEIVABLES

No. Other Receivable Type Counterparty Nominal Pension Program/ Other Benefits Description a b c d e f … Total DETAILS OF OTHER RECEIVABLES

<= 1 year >1 year Total a b c d e f
…
Total
DETAILS OF DUE PENSION BENEFIT LIABILITIES No.
Amount Pension Program/
Other Benefits
Description

<= 1 year >1 year Total a b c d e
…
Total
DETAILS OF DUE VOLUNTARY PENSION BENEFIT LIABILITIES No. Amount Description

No. Investment Type Counterparty Value Pension Program/ Other Benefits Description a b c d e f … Total DETAILS OF INVESTMENT LIABILITIES

No.
Details of Income
Received in Advance
Counterparty Value
Pension Program/
Other Benefits
Description a b c d e f
…
Total
DETAILS OF INCOME RECEIVED IN ADVANCE

No.
Details of Expenses
Still to be Paid
Counterparty Value
Pension Program/
Other Benefits
Description a b c d e f
…
Total
DETAILS OF EXPENSES STILL TO BE PAID

No. Other Liability Type Counterparty Value Pension Program/ Other Benefits Description a b c d e f … Total DETAILS OF OTHER LIABILITIES

No. Investment Type
Investment Valuation
Difference
Increase/
Decrease
Pension Program/
Other Benefits
Description a b c d e f
...
Total
Details of Investment Increase/Decrease

Participant Normal Contribution Employer Normal Contribution a b c d e f g ... Total Details of Contributions No. Name Group/ Individual PhDP Contribution Receipts Pension Program/ Other Benefits Description

No.
Type of Income Outside
Investment
Amount
Pension Program/
Other Benefits
Description a b c d e
...
Total
Details of Income Outside Investment

No.
Pension Fund Name that transfers
Amount
Pension Program/
Other Benefits
Details of Other Benefits *)
Description a b c d e f
...
Total
*) letter e:
Details of Transfers from Other Pension Funds Filled with Education Fund/Housing Fund/Religious Worship Fund/Disability Benefit/Death Benefit/Health Benefit/Severance Fund/Additional Benefit Fund

No. Expense Type Amount
Pension Program/
Other Benefits
Description a b c d e
...
Total
Details of Investment Expenses

No. Expense Type Amount
Pension Program/
Other Benefits
Description a b c d e
...
Total
Details of Expenses Outside Investment and Operations

No.
Type of Income
Tax
Amount
Pension Program/
Other Benefits
Description a b c d e
Total
Details of Income Tax

No.
Pension Fund Name that is transferred to Amount Pension Program/ Other Benefits Details of Other Benefits *) Description a b c d e f ... Total *) letter e:
Details of Transfers to Other Pension Funds Filled with Education Fund/Housing Fund/Religious Worship Fund/Disability Benefit/Death Benefit/Health Benefit/Severance Fund/Additional Benefit Fund

FORMAT II B
FORM AND STRUCTURE OF ANNUAL REPORTS FOR TECHNICAL REPORTS OF FINANCIAL INSTITUTION PENSION FUNDS
I. Pension Fund Profile
A. General Profile
Pension Fund Name :
General Register Book Number
(NBDU)
:
SID Number :
Taxpayer Identification Number (NPWP) :
Address :
a. Building/Floor/Room/Street :
b. City :
Postal Code :
c. Province :
d. Telephone 1 (area code-telephone) :
e. Telephone 2 (area code-telephone) :
f. Telephone 3 (area code-telephone) :
g. Facsimile (area code - facsimile)
:
h. Email :
i. Website :
B. Founders
Founder Name :
Address :
a. Building/Floor/Room/Street :
b. City :
Postal Code :
c. Province :
d. Telephone 1 (area code-telephone) :
e. Telephone 2 (area code-telephone) :
f. Telephone 3 (area code-telephone) :
g. Facsimile (area code - facsimile)
:
h. Email :
i. Website :
j. Founder Business Sector :
k. Founder Ownership Status
(SOE/Non-SOE)
:
C. Organization

Management
a. Is there any change in the Acting
Board of Directors or extension of the term of office of the Acting Board of Directors during the activity period? If Yes, has this been reported to the OJK?

b. Does the Acting Board of Directors have a basic knowledge certificate in the field of Pension Funds?
c. Does the Acting Board of Directors who has a basic knowledge certificate in the field of Pension Funds meet the minimum continuing education points?
d. Is there any change in the Board of Supervisors or extension of the term of office of the Board of Supervisors during the activity period? If Yes, has this been reported to the OJK? e. Do the number and composition of the Acting Board of Directors and the Board of Supervisors comply with the PDP and applicable legislation in the field of Pension Funds? f. Does the Acting Board of Directors have an Investment and/or Risk Management certificate?
2. Number of Pension Fund Employees Based on Education Level
SD
:
SMP
:
SMA
:
Diploma
:
S1
:
S2
:
S3
:
Total
:
3. List of Names and Positions of Pension Fund Employees
Under the Structure of the Acting Board of Directors
4. Third-Party Service Users:
No. Name Position a. Does the Pension Fund use the services of others to manage membership administration? If Yes, fill in the name of the Membership administration Manager: 12

5 etc b. Does the Pension Fund use the services of others to deposit ownership documents of assets? If Yes, fill in the name of the custodian used 5 etc
c. Does the Pension Fund use the services of an Investment Manager?
If Yes, fill in the list of names of
Investment Managers used (sorted by proportion of assets managed) 5 etc d. Does the Pension Fund use the services of an Appraiser? If Yes, fill in the list of information of Appraisers used:
5 etc
5. Contributions
a. Does the Employer pay contributions in the correct amount? b. Does the Employer pay contributions on time?
c. Are there voluntary contributions from Participants?
6. Other Benefits
Does the Pension Fund implement an Other Benefits program for Participants?
7. Investments
a. Are investment activities during the reporting period in accordance with the provisions of applicable legislation? b. Has information regarding investments been submitted to participants?
8. Governance
a. Does the Pension Fund have a Pension Fund Governance Guideline? b. Has the Pension Fund implemented Pension Fund Governance?
c. Information on Number and Date/Month/Year
of Adoption of Governance Guideline
D. Pension Fund Membership

Number of Active Pension Fund Employee Participants at the end
of the activity period:
Collective Participants/ from
Employer (persons) a. Pension Program b. Other Benefits Self-Managed Participants (persons) Total (persons) :
a. Pension Program b. Other Benefits
Total number of participants entitled to
delayed pension from the pension program at the end of the activity period :
Age Structure of Active Pension Program Participants
a. Number of Active Participants up to 20 :
20 to 30 :
30 to 40 :
40 to 50 :
above 50 :
b. Number of Participants entitled to delayed pension from the pension program up to 20 :
20 to 30 :
30 to 40 :
40 to 50 :
above 50 :
Estimated number of pension program participants who will reach normal retirement age in the next activity period :
Total number of employers who include
:
their employees in DPLK at the end of the activity period E. Pensioners and Parties Entitled to Pension Program Description Amount ≤ Rp 1,600,000,

Rp
1,600,000,
≤ Rp
500,000,000,
Rp
500,000,000,

Number of Benefit Recipients -
a. Number of Benefit
Recipients
Pension monthly at the end of the activity period (including those choosing maximum first payment 20%) -
i. Pensioners
ii. Widows/Widowers
iii. Children
iv. Parties designated
by
Participants or pensioners if
Participants or pensioners are not married and do not have children b. Number of Benefit Recipients Pension who receive payment lump sum during the activity period for reasons:
i. Pension
benefit monthly below the limit set by the minister
ii. Reasons
other than item b (i)
c. Number
of Benefit
Recipients
Pension undergo annuity purchase during the period
Distribution of the number
of pension benefit recipients based on the category of the size of the pension benefit received monthly at the end of the activity period
i. Pensioners
(persons)
ii. Widows/Widowers
iii. Children
iv. Parties designated by
Participants or pensioners if Participants or pensioners are not married and do not have children Statement by the Acting Board of Directors We, the Acting Board of Directors of the Pension Fund, declare that all data and information we submit in this technical report are true data and accurate according to the actual conditions of the Pension Fund. If it is later found that there is data/information that does not match the actual conditions, we are willing to be held accountable in accordance with applicable legislation. Place, Date (date/month/year) (signature) Full Name Position

II. Report on the Implementation of Good Corporate Governance for Pension Funds

Transparency of the Implementation of Good Corporate Governance for Pension Funds
a. Acting Board of Directors

Number, job titles, criteria, appointment dates, term of office,
citizenship, and domicile of Acting Board of Directors members No. Name Position Criteria Date of Appoint ment Term of Office Citizenship Domicile Last Formal Education And Professional Degree Competency And Fit Test 1. 2. Etc .
Concurrent positions of Acting Board of Directors members
No. Name
Position at
Pension Fund
Position at Other Pension Fund
Position at
Company and/or other institutions

Etc.
2.
1.
2.
Etc.
Etc
3) Frequency of Acting Board of Directors meetings held
within 1 (one) month.
No. Name Position
Number of Acting Board of Directors
Meetings (... meetings)
%
Attendance
Number of Physical
Attendances
Teleconference/ Video
Conference/Other Electronic Media
1.
2.
Etc

Family relationships of Acting Board of Directors members with other
Acting Board of Directors members, and/or the Board of Supervisors of the DPLK at the Pension Fund where the Acting Board of Directors member holds office. No. Name Family Relationship With Other Acting Board of Directors Board of Supervisors DPLK Yes No Note* Yes No Note* 1. 2. Etc Note:
 Type of family relationship: husband/wife/child/parent/sibling/in-law, etc. b. Board of Supervisors
Number, job titles, criteria, appointment dates, term of office,
citizenship, and domicile of Board of Supervisors members No. Name Position Criteria Date of Appoint ment Term of Office Citizenship Domicile Last Formal Education and professional degree Competency And Fit Test 1. 2. Etc.
Concurrent positions of Board of Supervisors members
No. Name
Position at
Pension Fund
Position at Other Pension Fund
Position at
Company and/or other institutions

Etc.
2.
1.
2.
Etc.
Etc.
3) Frequency of Board of Supervisors meetings held within 1 (one)
month.
No. Name Position
Number of Board of Supervisors
Meetings (... meetings) % Attendance
Number of Attendances

Physical
Teleconference/ Video
Conference/Other Electronic Media
1.
2.
Etc
4) Family relationships of Board of Supervisors members with other
Board of Supervisors members and/or Acting Board of Directors DPLK members, where the Board of Supervisors member holds office. No. Name Family Relationship With Other Board of Supervisors Acting Board of Directors DPLK Members Yes No Note* Yes No Note* 1. 2. Etc Note:
 Type of family relationship: husband/wife/child/parent/sibling/in-law, etc.
c. Board of Supervisors Supervision Results Report
Board of Supervisors activity report on the implementation of Good Corporate Governance for Pension Funds Supervision Results Recommendations  Filled with details of the Board of Supervisors' assessment of the implementation of Good Corporate Governance for Pension Funds in the form of assessment of quantitative and qualitative aspects of Good Corporate Governance for Pension Funds and factors affecting performance, and efforts to improve Pension Fund performance, if according to the assessment there is a decline in Pension Fund performance d. Committees

Functions under the Acting Board of Directors DPLK
No.
Name
Function
Name
Member
Position*
Work
Tenure
Appoint ment
SK
Number of
Meetings in One Year

Internal
Audit
Function
1.
2.
Etc

No.
Name
Function
Name
Member
Position*
Work
Tenure
Appoint ment
SK
Number of
Meetings in One Year
2.
Risk
Management
Function
1.
2.
Etc
3. Compliance
Function
1.
2.
Etc
Etc
2) Committees under the Board of Supervisors
No.
Name
Committee
Name
Member
Position*
Work
Tenure
Appoint ment
SK
Number of
Meetings in One Year
1.
Audit
Committee
1.
2.
Etc
2.
Risk
Monitoring
Committee
1.
2.
Etc
3. Nomination and
Remuneration
Committee
1.
2.
Etc
Etc e. Implementation of external audit functions.
No. Description Year n-2 Year n-1 Year n 1.
Name of Public Accounting Firm
2. Name of Public Accountant
3. Audit Period
4.
Appointment by the Board of Supervisors *) Note:
 Date of Appointment by the Board of Supervisors f. Implementation of remuneration policies and other facilities for members of the Acting Board of Directors, Board of Supervisors, and Employees. Number of members of the Acting Board of Directors, Board of Supervisors, and Employees who receive remuneration packages in 1 (one) year grouped according to income level as follows:
Total Remuneration per person in 1 year *) Number of Acting Board of Directors Number of Board of Supervisors Employees Above Rp2 billion Above Rp1 billion to Rp2 billion Above Rp500 million to Rp1 billion Rp500 million and below Note:
 received in cash g. Outsourcing of Investment Management *) No. Type of Investment Name of Outsourcing Company Investment Value No. Agreement % of total Investment Portfolio 1. 2. etc Note:
 Pension Funds only outsource Investment Management in the form of KPD h. Disclosure of other important matters No. Description Checklist *) If Yes, Yes No Explain 1. Resignation or dismissal of external audit
2. Material transactions with related parties )
3.
Ongoing Conflicts of Interest.
4.
Other material information regarding the Pension Fund
5. The Pension Fund has a compliance function
6. The Pension Fund has internal audit
7.
The Pension Fund has a risk management function 8.
The Pension Fund has an investment management function/unit

No. Description
Checklist *) If Yes,
Yes No Explain
9.
The Pension Fund has a special work unit and/or appoints a PJK official responsible for the implementation of the APU and PPT program *)  choose one answer by placing a “√” mark Related Parties are individuals or companies/bodies that have a control relationship with the Pension Fund, either directly or indirectly, through ownership, management, and/or financial relationships

Explain and include the Information Number and Date/Month/Year
of Adoption of the APU PPT Guideline

Self-Assessment of the Implementation of Good Corporate Governance
for Pension Funds
The questionnaire on the Implementation of Good Corporate Governance for Pension Funds is filled out by the Pension Fund concerned. The filling of this questionnaire is done by answering questions/statements in the questionnaire. Filling Method:
Generally, the answers to the Questions/Statements mentioned consist of 5 criteria as follows (except for answers requiring different criteria) :
A= The Pension Fund concerned DOES NOT HAVE written policies regarding the Question/Statement in question. B= The Pension Fund concerned HAS written policies regarding the Question/Statement in question, but the policy has NOT been implemented. C= The Pension Fund concerned HAS written policies regarding the Question/Statement in question, but the policy has NOT been implemented CONSISTENTLY. D= The Pension Fund concerned HAS written policies regarding the Question/Statement in question, the policy is IMPLEMENTED CONSISTENTLY but has NOT BEEN UPDATED periodically. E= The Pension Fund concerned HAS written policies regarding the Question/Statement in question and the policy is IMPLEMENTED CONSISTENTLY and UPDATED periodically.

Interpretation of Results
An assessment is needed to interpret the numbers obtained in answering the questions of this Questionnaire, the majority of whose answers consist of 5 (five) scales starting from the lowest assessment (A/ No), to the highest assessment (E/ Yes). Specifically for the answer "A/No" on assessment criteria that have been required in applicable legislation (mandatory), a negative number is given. For groups of Questions/Statements skipped due to "None" and which are not "not applicable", in the result interpretation they must still be considered by giving the same score as the answer " A/No". A. BUSINESS ETHICS AND CODE OF CONDUCT

The Pension Fund has a Vision, Mission, and Values.
A B C D E
The Pension Fund has a Business Ethics Policy which includes:
2.1.General policy directing towards applicable legislation and code of ethics. A B C D E 2.2.Policy for Pension Fund organs. A B C D E 2.3.Policy for employees. A B C D E 2.4.Policy for Participants and/or parties entitled to receive pension benefits. A B C D E 2.5.Policy for business partners. A B C D E 2.6.Policy for other pension funds. A B C D E
The Pension Fund has a Code of Conduct
which is an elaboration of Values and
Business Ethics.
A B C D E
The Code of Conduct includes guidelines on:
4.1.Conflicts of interest. A B C D E
4.2.Giving gifts and donations. A B C D E 4.3.Compliance with regulations. A B C D E 4.4.Confidentiality of information. A B C D E 4.5.Reporting of violations and protection for whistleblowers. A B C D E
In carrying out their duties, the Acting Board of Directors, Board
of Supervisors, and pension fund employees :
5.1.Make a statement "no conflict of interest" regarding every decision taken by the authorized party. No Yes 5.2.Make a statement every year regarding the implementation of the code of conduct established by the Pension Fund. No Yes 5.3.Make a statement every year not to receive and/or give anything that could influence decision-making. No Yes
The Pension Fund records its
assets, liabilities, and equity correctly using generally accepted accounting principles or special accounting principles applicable to pension funds. No Yes
Has a complaint system regarding
violations of the code of conduct,
Pension Fund regulations and applicable legislation and matters related to Participants that guarantee protection for Whistleblowers. A B C D E B. PENSION FUND ORGANS a. Founders Founders have carried out the following according to their functions:
1.1.Internal control. A B C D E
1.2.Risk management. A B C D E
1.3.Implementation of GCG. A B C D E
1.4.Following up audit findings and recommendations from work units that perform the internal audit function of the Pension Fund, external audit of the Pension Fund, and/or the results of supervision by the Financial Services Authority. A B C D E b. Acting Board of Directors
Composition of Appointment and Dismissal of Acting Board of Directors
1.1. The DPLK Founder acts as the
Board of Directors and in management the DPLK Founder must No Yes appoint the Acting Board of Directors.
1.2. The number of Acting Board of Directors
members has been adjusted to the complexity of the Pension Fund but still considering the effectiveness of decision-making. No Yes
1.3. The Acting Board of Directors consists of members who
collectively have competence*) such as:
1.3.a Investment field. No Yes
1.3.b Risk Management field. No Yes
Requirements for Acting Board of Directors Members
2.1. Acting Board of Directors members
meet the provisions of the articles of association.
No Yes
2.2. Acting Board of Directors members
meet the competency and fit requirements according to the regulations of the supervisory authority. No Yes
2.3. Acting Board of Directors members
must understand and implement good corporate governance for Pension Funds. A B C D E
2.4. Acting Board of Directors members
are prohibited from using the Pension
Fund for personal, family, business group and/or other parties' interests that harm the interests of the Pension Fund. No Yes
2.5. Do not hold concurrent positions as members
of the Board of Supervisors or DPS on the same Pension Fund. No Yes
2.6. Do not hold concurrent positions as directors
or board of commissioners or equivalent in companies and/or other institutions except on subsidiary companies where the pension fund has participation, both No Yes

directly or indirectly.
2.7. Acting Management members do not hold concurrent positions as members of Management, Acting Management, the Supervisory Board, or DPS in other Pension Funds.
No Yes

Functions of Acting Management
3.1. Management
3.1.1. Acting Management is fully responsible for the management of the Pension Fund.
A B C D E
3.1.2. Acting Management manages available resources effectively and efficiently, including ensuring the availability of human resources with specific qualifications to perform their functions.
A B C D E
3.1.3. Acting Management considers the fair interests of stakeholders.
A B C D E
3.1.4. Acting Management has and complies with rules of procedure and work guidelines (charter) regulated in the Pension Fund Regulations (PDP) and relevant pension fund legislation.
A B C D E
3.1.5. Acting Management overseeing the compliance function cannot be held concurrently by Acting Management overseeing the funding, financial, or investment functions, unless the number of Acting Management members is 2 (two), in which case the compliance function may be held concurrently by the Acting Management member overseeing the financial function.
No Yes

3.2. Risk Management
3.2.1. Acting Management formulates and implements a Risk Management System covering all aspects of the Pension Fund's activities.
A B C D E
3.2.2. The Pension Fund has a Risk Monitoring Committee and a Risk Management Unit.
No Yes

3.3. Internal Control
3.3.1. The Pension Fund has an internal supervision function.
No Yes
3.3.2. Responsible for the execution of its duties to the Founder.
No Yes

Accountability of Acting Management
4.1. Acting Management prepares an accountability report on the management of the Pension Fund in the form of an Annual Report.
No Yes
4.2. Criteria for the Annual Report include:
4.2.1. Containing at least:
a. Financial statements. No Yes b. Pension Fund activity report. No Yes
c. Report on the implementation of good corporate governance for the Pension Fund. No Yes
4.2.2. Approved by the Founder. No Yes
4.2.3. Specifically, the financial report must be endorsed by the Founder. No Yes

4.3. Meetings of Acting Management
4.3.1. Every strategic policy and decision must be decided through an Acting Management meeting, taking into account supervision according to the duties and responsibilities of the Supervisory Board.
No Yes
4.3.2. Acting Management holds meetings periodically at least 1 (one) time in 1 (one) month.
No Yes
4.3.3. Acting Management establishes meeting rules of procedure.
No Yes
4.3.4. Minutes of every Acting Management meeting are recorded.
No Yes
4.3.5. Meeting minutes record dissenting opinions with the decisions taken in the meeting (if any).
A B C D E
4.3.6. Every member of Acting Management, whether attending or not attending the meeting, has the right to receive a copy of the Minutes of the Acting Management Meeting.
No Yes

c. Supervisory Board

Composition, Appointment, and Dismissal of the Supervisory Board
1.1. The number of Supervisory Board members has been adjusted to the complexity of the Pension Fund while still considering the effectiveness of decision-making.
No Yes
1.2. The entire Supervisory Board consists of members who collectively possess competencies relevant to their positions.
No Yes
1.3. Does not hold concurrent positions as Acting Management, or DPS in the same Pension Fund, or as Supervisory Board, Management, or DPS in another Pension Fund.
No Yes
Competence and Integrity of the Supervisory Board
2.1. Meets the Fit and Proper Test requirements.
No Yes
2.2. Monitors the effectiveness of the implementation of good corporate governance for the Pension Fund.
A B C D E
2.3. Does not utilize the Pension Fund for personal, family, business group, or other parties' interests, which could harm the Pension Fund.
No Yes
Supervisory Functions of the Supervisory Board
3.1. Fully responsible for the supervision of the Pension Fund.
A B C D E
3.2. Executes the duties and responsibilities of the Supervisory Board as regulated in the PDP and relevant pension fund legislation independently.
No Yes
3.3. The Supervisory Board holds meetings periodically at least 1 (one) time in 3 (three) months.
No Yes
3.4. Minutes of every Supervisory Board meeting are recorded.
No Yes
3.5. Meeting minutes record dissenting opinions with the decisions taken in the meeting.
A B C D E
3.6. Every member of the Supervisory Board, whether attending or not attending the meeting, has the right to receive a copy of the Supervisory Board meeting minutes.
No Yes
Supervisory Board Committees (answered if applicable)
4.1. Audit Committee
No
Yes
Continue to
4.1.7.
The Audit Committee serves as a facilitator for the Supervisory Board to ensure the following:
4.1.1. The Pension Fund's internal control structure is implemented well.
A B C D E
4.1.2. Internal audit is conducted according to applicable audit standards.
A B C D E
4.1.3. Follow-up on internal audit findings is implemented by management.
A B C D E
4.1.4. External audit has been conducted according to applicable auditing standards.
No Yes
4.1.5. Follow-up on external audit findings is implemented by management.
A B C D E
4.1.6. Members of the Audit Committee consist of:
a. Supervisory Board members. No Yes b. Parties outside the Pension Fund who do not have financial, managerial, and/or family relationships with the Supervisory Board, Acting Management of the Pension Fund, and/or the Founder, or other relationships that could affect their ability to act independently. No Yes
4.1.7. For Pension Funds that do not have an Audit Committee, there are Supervisory Board members who specifically serve to ensure the following:
a. The Pension Fund's internal control structure has been implemented well. A B C D E b. Internal audit is conducted according to applicable audit standards. A B C D E
c. Follow-up on internal audit findings is implemented by management.
A B C D E d. External audit has been conducted according to applicable audit standards. No Yes e. Follow-up on external audit findings is implemented by management. A B C D E

4.2. Risk Monitoring Committee
No
Yes
Continue to
4.2.4.
The Risk Monitoring Committee serves as a facilitator for the Supervisory Board for the following matters:
4.2.1. Assessing the quality of risk management policies.
A B C D E
4.2.2. Assessing the effectiveness of risk management applied by the Pension Fund, including assessing the risk tolerance taken by Acting Management.
A B C D E
4.2.3. Members of the Risk Monitoring Committee consist of:
a. Supervisory Board members representing Participants. No Yes b. Other parties. No Yes
4.2.4. For Pension Funds that do not have a Risk Monitoring Committee, there are Supervisory Board members who specifically serve for the following matters:
a. Assessing the quality of risk management policies.
A B C D E b. Assessing the effectiveness of risk management applied by the Pension Fund, including assessing the risk tolerance taken by Acting Management. A B C D E

4.3. Nomination and Remuneration Committee
No
Yes
Continue to
4.3.4.
The Nomination and Remuneration Committee serves as a facilitator for the Supervisory Board for the following matters:
4.3.1. Facilitator for the Supervisory Board in helping the Founder set criteria and select candidates for the Supervisory Board and Acting Management of the Pension Fund.
A B C D E
4.3.2. Facilitator for the Supervisory Board in helping the Founder establish a remuneration system.
A B C D E
4.3.3. Members of the Nomination and Remuneration Committee consist of:
a. Supervisory Board members. No Yes b. Other parties. No Yes
4.3.4. For Pension Funds that do not have a Nomination and Remuneration Committee, there are Supervisory Board members who specifically serve for the following matters:
a. Helping the Founder set criteria and select candidates for the Supervisory Board and Acting Management of the Pension Fund. A B C D E b. Helping the Founder establish a remuneration system. A B C D E

C. HEALTHY BUSINESS PRACTICES
External Auditor

External Auditors (public accounting firms) conduct independent examinations of the truthfulness of the Pension Fund's financial statements.
No Yes
The appointed public accounting firm (KAP) is registered with the Financial Services Authority (OJK).
No Yes
Action Plan
No.
Corrective Action
Target Completion
Completion Obstacles
Remarks

...

Implementation of Anti-Fraud Strategy
Name of Pension Fund..............................
FRAUD CONTROL REPORT AND ANTI-FRAUD STRATEGY IMPLEMENTATION REPORT YEAR …… a. Inventory of Fraud Incidents and Follow-up Type Fraud a) Date of Fraud Occurrence Division/Department of Fraud Occurrence Parties Involved b) Position Loss in Rupiah c) Action by Pension Fund d) Weakness/ Cause of Fraud e) Follow up/ Correction f) Chronol ogy of Inciden t Fraud g) b. Progress of Anti-Fraud Strategy Implementation

Prevention:
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………………………
Detection:
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………………………
Investigation, Reporting, and Sanctions:
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………………………
Monitoring, Evaluation, and Follow-up:
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………………………
EXPLANATION FOR REPORT FILLING:
a) Types of Fraud include, among others, fraud, deception, asset embezzlement, information leakage, criminal acts of the Pension Fund, or others. b) Parties involved include all parties indicated to be involved/participating in the Fraud. If more than 1 (one) party is involved, the role of each party is explained. c) Losses are filled with losses that have occurred or estimated losses. d) Pension Fund actions are the Pension Fund's response to Fraud incidents, either actions against perpetrators, harmed parties, or other actions. Actions against Fraud perpetrators include, among others, administrative personnel sanctions and/or compensation obligations. Actions against harmed parties include, among others, compensation and/or efforts to restore reputation. Other actions include, for example, reports to competent authorities and/or legal efforts. e) Weaknesses/causes of Fraud are identifications of weaknesses in the Pension Fund that caused the Fraud, which can be policy, system, and procedure weaknesses, or human resources, or other causes not originating from the Pension Fund. f) Follow-up/correction are efforts that have been or will be undertaken by the Pension Fund regarding weaknesses that caused the Fraud. g) Briefly explain the process of prevention, detection, investigation, reporting sanctions, and monitoring, evaluation, and follow-up steps for the implementation of the anti-Fraud strategy during the reporting period.

III. Evidence of Fulfillment of Continuing Requirements for Acting Management and Employees Handling Investments
FORM:
FORM SELF ASSESSMENT
REPORT ON FULFILLMENT OF CONTINUING REQUIREMENTS FOR ACTING MANAGEMENT AND EMPLOYEES HANDLING INVESTMENTS Name of Pension Fund :
Report Letter Number :
Date of Report
Letter :
Contact Person (Name,
Tel/email)
:
NO DESCRIPTION OF LEGAL BASIS YES NO REMARKS 1.
The report on fulfillment of continuing requirements is submitted by the Acting Management of the Pension Fund to the OJK no later than April 30 of the following year. o POJK 3/POJK.05/2015 o POJK 5/POJK.05/2018 o POJK 29/POJK.05/2018
2. Evidence of fulfillment of continuing requirements
Additional remarks (if necessary):
No Name
Type
Principal
Party
*) *)
No and date
SK
(FPT)
Type
Fulfiller
*)
Title of
Activit y
Organizer of
Activity
*)
Name of
Organiz er
Date of
Executi on
Fulfil ment
Year
Evidence of fulfill ment
*)
..... o Acting
Manage ment o Employ ee
..... o Attend seminar, worksho p, or other similar activity o Attend course, trainin g, or similar educati onal progra m o Write paper,
article,
or other written work published o Be a speaker in seminar, worksho p, or other similar activity, be a teacher or instruc tor in course, trainin ..... o Financial service superviso ry agency in and outside the country o Financial service institution association in and outside the country o Higher education in and outside the country o Training institution obtainin g license from competen t authorit y ..... ..... ..... o Certifi cate (numbe r and date) o Attend ance proof o Other , that is
.....

n, or similar educati onal progra m
Remarks:

Filling method: click twice in the box, then select "Checked"
*) Select one
) Specifically for acting management
*) for all employees handling investments
This Self Assessment Form is prepared based on the provisions of OJK Regulation No. 3/POJK.05/2015 on Pension Fund Investments; OJK Regulation No.5/POJK.05/2018 on Periodic Reports of Pension Funds, and OJK Regulation No.29/POJK.05/2018 on Amendments to Financial Services Authority Regulation Number 3/POJK.05/2015 on Pension Fund Investments
Types of fulfillment of continuing requirements related to knowledge in the field of investments and/or risk management as regulated in OJK Regulation No. 3/POJK.05/2015 on Pension Fund Investments.

FORMAT II C
FORM AND STRUCTURE OF OTHER PENSION FUND REPORTS FOR FINANCIAL INSTITUTIONS A. Report on Consumer Complaint Services and Resolution at Financial Service Business Actors The form and structure of consumer complaint reports and follow-up on services and resolution of consumers as referred to in the Financial Services Authority Regulation regarding Consumer Complaint Services in the Financial Service Sector refers to the form and structure as contained in the Appendix of the Financial Services Authority Circular Letter regarding Guidelines for Implementation of Consumer Complaint Services in the Financial Service Sector. B. Report on Appointment of Public Accountants and/or Public Accounting Firms in the Context of Audit of Annual Historical Financial Information The form and structure of the report on the appointment of public accountants and/or public accounting firms in the context of audit of annual historical financial information as referred to in the Financial Services Authority Regulation regarding the Use of Public Accountant and Public Accounting Firm Services in Financial Service Activities refers to the form and structure as contained in the Appendix of the Financial Services Authority Circular Letter regarding Procedures for the Use of Public Accountant and Public Accounting Firm Services in Financial Service Activities.
C. Report on Audit Committee Evaluation Results Regarding the Implementation of Audit Services for Annual Historical Financial Information by Public Accountants and/or Public Accounting Firms
The form and structure of the report on the Audit Committee's evaluation results regarding the implementation of audit services for annual historical financial information by public accountants and/or public accounting firms as referred to in the Financial Services Authority Regulation regarding the Use of Public Accountant and Public Accounting Firm Services in Financial Service Activities refers to the form and structure as contained in the Appendix of the Financial Services Authority Circular Letter regarding Procedures for the Use of Public Accountant and Public Accounting Firm Services in Financial Service Activities.

D. Periodic Actuarial Report a. Actuarial Report for Pension Funds Operating Defined Contribution Pension Programs and Making Periodic Pension Benefit Payments General Data Report Number Report Date NBDU Name of Pension Fund Address of Pension Fund Reporting Period Reporting Month Fiscal Year Type of Reporting Period Annual Report Name of Acting Management Position of Acting Management

Actuarial Statement
1.1 Pension Fund Actuarial Information:

Actuary Name;
Actuarial Firm Name;
Office Address and Telephone Number;
STTD No. Actuarial Consultant (with valid license in IKNB);
I, the undersigned, declare that:

All data received is complete and can be accounted for for the purpose of preparing the Actuarial Report to the extent of the actuary's knowledge, and for that purpose, testing has been conducted to assess its reliability.
The report meets the provisions of pension fund legislation.
The report meets the Employer's provisions.
The report is prepared based on the PDP; and
The report is prepared based on actuarial practice standards for Pension Funds applicable in Indonesia;
Place, date of creation
Signed, for the Periodic Actuarial Report as referred to in the Financial Services Authority Regulation regarding Pension Fund Funding

Name
No. Indonesia Actuarial Association (PAI) Register Public Actuary License No.:
2. Actuarial Valuation Date
Actuarial valuation date reported
Actuarial valuation date of previous period
3. Purpose of Preparation
4. Summary of PDP including payment patterns and normal retirement age
5. Summary of number of Participants, widows/widowers, and children choosing periodic Pension Benefit payments
Description DD-MM-YYYY
(reporting period)
DD-MM-YYYY
(previous period)
Active Participants
Passive Participants

Retirees
Deferred pensions
Widows/widowers
Children
Designated parties

Interest rate used
Cash Flow Projection
Actuarial Gain or Loss Analysis
Investment Results and Cost Analysis
Conversion Table
Conclusions and Recommendations

E. Pension Fund Business Plan
BUSINESS PLAN REPORT
Year ...............................
(fill in name and address of Pension Fund) Approved, Supervisory Board (Pension Fund Stamp) N a m e Full Name Position 20xx Management, (Pension Fund Stamp) N a m e Full Name Position Business Plan Report in accordance with Article 3 paragraph (1) of POJK Number 24/POJK.05/2019 regarding Business Plans of Non-Bank Financial Service Institutions, with a submission deadline no later than November 30 before the year the Business Plan begins.

TABLE OF CONTENTS
FORMAT FOR PENSION FUND BUSINESS PLAN FOR FINANCIAL INSTITUTIONS Format 1 : Pension Fund Profile Format 2 : Executive Summary Format 3 : Evaluation of Previous Business Plan Period Implementation Format 4 : Vision, Mission, and Business Strategy Format 5 : Business Activity Plan Format 6 : Business Activity Development or Expansion Plan Format 7 : Investment Plan Format 8 : Funding Plan Format 9 : Office Network or Distribution Channel Development and/or Change Plan Format 10 : Organization, Human Resources, and/or Information Technology Development Plan Format 11 : Report on Plans and Realization of Activities to Improve Financial Literacy and Inclusion for Consumers and/or the Public Format 12 : Financial Statement Projections Format 13 : Projections of Certain Ratios and Other Items, and Assumptions Used Format 14 :
Other Information

Format 1 : Pension Fund Profile

General Pension Fund Information

Name of Pension Fund
Pension Fund Code
Approval Decree
Program
Acting Management
Supervisory Board
Office Address
Report Date
Business Plan Year

Pension Fund Organizational Structure
(Filled with the Pension Fund organizational structure chart)
General Founder Information

Founder Name
Address
Board of Directors
Board of Commissioners
Field of Business
Format 2 : Executive Summary

Short-Term Strategic Plans and Steps for Period 1 (One) Year 1)
...............................................................................................................................
...............................................................................................................................
....................................................
Medium-Term Strategic Plans and Steps for Period 3 (Three) Years

...............................................................................................................................
...............................................................................................................................
....................................................
3. Long-Term Strategic Plans and Steps for Period 5 (Five) Years 1)
...............................................................................................................................
...............................................................................................................................
....................................................
Remarks :

Includes, among others, the implementation of good corporate governance for the Pension Fund, risk management implementation, and improvement of Pension Fund investment results, improvement of pension benefits or other benefits, and improvement of Pension Fund efficiency

Financial Indicators
(in full Rupiah units)
No Description
Performance
Sept X-1
Projection
Dec X-1 June X Dec X
Net Assets
Investment Assets
Investment Income
Investment Expenses
Operational Expenses
Remarks:
X-1 : year of report preparation.
X : year of business plan position.
Description of Pension Fund Financial Conditions
...............................................................................................................................
...............................................................................................................................
.................................................

Description of Pension Fund financial conditions reflected in financial indicators and financial ratios, including reasons for increases/decreases

Financial Ratios
No Description
Performance
Sept X-1
(%)
Projection (%)
Dec X-1 June X Dec X

Investment Income Ratio (ROI)
2.
Investment Income to Assets Ratio (ROA) 3.
Operational Expense Ratio (BOPO)

Format 3: Evaluation of the Implementation of the Previous Business Plan Period

Comparison Between Business Plan and Business Plan Realization Each Year (Ignore if your Pension Fund is a new Pension Fund and/or reporting on the business plan for the first time).
(Detail the current business plan and its realization with the business plan each year. In this section, the Pension Fund can view the Pension Fund's performance during that period by comparing the business plan with the business plan realization. The table example below can be modified in more detail according to the Pension Fund's needs)

Indicator	20XX-1 Business Plan	Realization Achievement
Net Assets	(1)	(2)
Investment Assets
Investment Income
Investment Expenses
Operational Expenses
Investment Income Ratio (ROI)
Investment Income to Assets Ratio (ROA)
Operational Expense Ratio (BOPO)

Challenges Faced and Problem-Solving Efforts
....................................................................................................................
....................................................................................................................
.............................

Clearly state the challenges faced in implementing the established plans and the solutions to those problems.

Problem-Solving Efforts
...............................................................................................................................
...............................................................................................................................
................................

Clearly state the solutions to the problems.

Format 4: Vision, Mission, and Business Strategy

Pension Fund Vision *
...............................................................................................................................
...............................................................................................................................
.......

The vision is a description of the Pension Fund's condition in the future and represents the Pension Fund's aspiration. The vision is a statement to answer the question of the Pension Fund's direction ahead.

Pension Fund Mission
..............................................................................................................................
..............................................................................................................................
.........

The mission is an elaboration of the vision, where the mission details a careful analysis of the benefits desired by Participants. The mission also details the existing environmental and market conditions and the Pension Fund's anticipation for the future.

Pension Fund Business Strategy
| No | Target | Policy | Strategy |
| :--- | :--- | :--- | :--- |
| 1. | a) 1) 2) b) 1) 2) c) dst dst | | |
| 2. | a) 1) 2) b) 1) 2) c) dst | | |

(Plan regarding the implementation of business activities previously carried out by the Pension Fund with reference to legislation regarding the administration of Pension Funds. Can be added with reasons and considerations in compiling the said plan and strategies to realize the said plan)

Format 6: Plan for Development or Expansion of Business Activities

No	Type of Business Activity	General Description of Business Activity	Time of Implementation of Business Activity	Objective of New Business Activity	Relevance of New Business Activity to Company Business Strategy	Risks of Implementation of New Business Activity	Risk Mitigation of Implementation of New Business Activity	Reasons and Strategic Considerations	Notes

Note:
a. The Plan for Development or Expansion of Business Activities includes the plan for the implementation of Pension Fund business activities, investment packages, Other Benefits based on approval from the Financial Services Authority (OJK), and plans for the implementation of business activities that must be reported to the Financial Services Authority (OJK). b. In accordance with the POJK regarding Contributions, Pension Benefits, and Other Benefits administered by Pension Funds, it can be filled in regarding other benefits.

Pension Fund business activities categorized as a form of development or expansion of business activities are business activities that:
a. have never been done before by the Pension Fund, such as the administration of other benefit programs for Pension Funds that have not yet administered other benefit programs or the periodic payment of pension benefits by Pension Funds that administer defined contribution pension programs; or b. have been carried out previously by the Pension Fund, but involve development that changes or increases certain Risk exposures in the Pension Fund, such as changes in the investment package offer for Multi-Fund Pension Funds (DPLK).

Format 7: Investment Plan

Investment Composition

Based on Acquisition Value

No	Type of Investment	Actual as of 30 Sept 20XX-1	Projection as of 31 Dec 20XX-1	Projection as of 30 Jun 20XX	Projection as of 31 Dec 20XX
		Nominal %	Nominal %	Nominal %	Nominal %
1.	Bank Savings
2.	On-call Deposits at Banks
3.	Time Deposits at Banks
4.	Bank Certificates of Deposit
5.	Securities issued by Bank Indonesia
6.	Government Securities
7.	Stocks listed on the Indonesia Stock Exchange
8.	Corporate Bonds listed on the Indonesia Stock Exchange
9.	Corporate Sukuk listed on the Indonesia Stock Exchange
10.	Regional Bonds/Sukuk
11.	Mutual Funds
12.	MTN
13.	Asset-Backed Securities
14.	Real Estate Investment Funds in the form of Collective Investment Contracts
15.	Infrastructure Investment Funds in the form of Collective Investment Contracts
16.	Options Contracts and Futures Contracts for Securities listed on the Indonesia Stock Exchange
17.	REPO
18.	Direct Participation
19.	Land in Indonesia
20.	Buildings in Indonesia
21.	Land and Buildings in Indonesia

Based on Fair Value

No	Type of Investment	Actual as of 30 Sept 20XX-1	Projection as of 31 Dec 20XX-1	Projection as of 30 Jun 20XX	Projection as of 31 Dec 20XX
		Nominal %	Nominal %	Nominal %	Nominal %
1.	Bank Savings
2.	On-call Deposits at Banks
3.	Time Deposits at Banks
4.	Bank Certificates of Deposit
5.	Securities issued by Bank Indonesia
6.	Government Securities
7.	Stocks listed on the Indonesia Stock Exchange
8.	Corporate Bonds listed on the Indonesia Stock Exchange
9.	Corporate Sukuk listed on the Indonesia Stock Exchange
10.	Regional Bonds/Sukuk
11.	Mutual Funds
12.	MTN
13.	Asset-Backed Securities
14.	Real Estate Investment Funds in the form of Collective Investment Contracts
15.	Infrastructure Investment Funds in the form of Collective Investment Contracts
16.	Options Contracts and Futures Contracts for Securities listed on the Indonesia Stock Exchange
17.	REPO
18.	Direct Participation
19.	Land in Indonesia
20.	Buildings in Indonesia
21.	Land and Buildings in Indonesia

Investment Return Plan

No	Type of Investment	Actual as of 30 Sept 20XX-1	Projection as of 31 Dec 20XX-1	Projection as of 30 Jun 20XX	Projection as of 31 Dec 20XX
		Real Investment Return	Unrealized Investment Return	Investment Expenses	Net Investment Return	Real Investment Return	Unrealized Investment Return	Investment Expenses	Net Investment Return	Real Investment Return	Unrealized Investment Return	Investment Expenses	Net Investment Return	Real Investment Return	Unrealized Investment Return	Investment Expenses	Net Investment Return
		a	b	c	d=(a+b)-c	a	b	c	d=(a+b)-c	a	b	c	d=(a+b)-c	a	b	c	d=(a+b)-c
1.	Bank Savings
2.	On-call Deposits at Banks
3.	Time Deposits at Banks
4.	Bank Certificates of Deposit
5.	Securities issued by Bank Indonesia
6.	Government Securities
7.	Stocks listed on the Indonesia Stock Exchange
8.	Corporate Bonds listed on the Indonesia Stock Exchange
9.	Corporate Sukuk listed on the Indonesia Stock Exchange
10.	Regional Bonds/Sukuk
11.	Mutual Funds
12.	MTN
13.	Asset-Backed Securities
14.	Real Estate Investment Funds in the form of Collective Investment Contracts
15.	Infrastructure Investment Funds in the form of Collective Investment Contracts
16.	Options Contracts and Futures Contracts for Securities listed on the Indonesia Stock Exchange
17.	REPO
18.	Direct Participation
19.	Land in Indonesia
20.	Buildings in Indonesia
21.	Land and Buildings in Indonesia
...

Considerations Underlying the Investment Plan
........................................................................................................................................
........................................................................................................................................
........................................

(Filled with considerations or assumptions used by the Board of Trustees as the basis for determining the investment plan in accordance with the POJK regarding Pension Fund Investments)

Format 8: Funding Plan

(Funding plan that generally comes from contributions or the results of its development. Contributions can be made by the employer alone or jointly between the employer and the worker (participant))

Contribution Projection

Description	Actual as of 30 Sept 20XX-1	Projection as of 31 Dec 20XX-1	Projection as of 30 Jun 20XX	Projection as of 31 Dec 20XX
Employer Contribution
Participant Contribution
Total Contribution Fund

Note:
X-1: year of report compilation.
X: year of the business plan position.

Projection of Number of Participants

Participant Number Table

Description	Actual as of 30 Sept 20XX-1	Projection as of 31 Dec 20XX-1	Projection as of 30 Jun 20XX	Projection as of 31 Dec 20XX
Pension Program Participants
Other Benefit Program Participants
Total Participants

Note:
X-1: year of report compilation.
X: year of the business plan position.

Reasons and Considerations *
.........................................................................................................................
.........................................................................................................................
...................

Filled with an explanation of participants who are the target, whether individual or group participants, and the targeted geographic distribution.

Strategy *
.........................................................................................................................
.........................................................................................................................
...................

Filled with the strategy to achieve the target number of participants.

Format 9: Plan for Development and/or Change of Office Network or Distribution Channels

(Plan for development and/or change of office network or distribution channels at least includes plans for opening and merging offices outside the head office.)

Note:

Filled with the month of the planned implementation time.
For locations in the DKI Jakarta region, at least mention the name of the DKI Jakarta province. For locations outside the DKI Jakarta region, at least mention the name of the Regency/City.
Detailed notes can be attached on a separate sheet.

Format 10: Plan for Organizational, Human Resources, and/or Information Technology Development

Organizational Development Plan

Description Regarding Organizational Development Plan*

No	Change in Office Network	Implementation Time 1	Location 2	Notes 3
A. Opening
1.
2.
B. Merging
1.
2.
C. Address Change
1.
2.
D. Office Closure
1.
2.
...

Filled with an explanation regarding the organizational development plan, including plans for the formation of work units/divisions, plans for changing work units/divisions, and plans for forming committees, adjusted to the size and complexity of the Pension Fund's business.

Reasons and Considerations*
.........................................................................................................................
.........................................................................................................................
...................

Filled with reasons/considerations in compiling the organizational development plan.

Strategy*
.........................................................................................................................
.........................................................................................................................
...................

Filled with the strategy to realize the organizational development plan.

Human Resources Fulfillment Plan

Description Regarding Human Resources Fulfillment Plan

No	Level	Position	Number of HR as of 30 Sept 20XX-1	Q4 20XX-1 (+)* (-)*	Q1 20XX (+) (-)	Q2 20XX (+) (-)	Q3 20XX (+) (-)	Q4 20XX (+) (-)
1.
2.
...
Total

Filled with the addition and reduction of the number of employees.

Reasons and Considerations*
.........................................................................................................................
.........................................................................................................................
...................

Filled with reasons/considerations in compiling the human resources fulfillment plan.

Strategy*
.........................................................................................................................
.........................................................................................................................
...................

Filled with the strategy to realize the human resources fulfillment plan.

Plan for Implementation of Human Resources Education and Training for Trustees, Board of Trustees Executors, Supervisory Board, and Employees

Human Resources Development Plan Table

No	Material/Topic	Participant Name	Position	Certification Already Held	Training Time
1.
2.
...

Reasons and Considerations*
.........................................................................................................................
.........................................................................................................................
...................

Filled with reasons/considerations in compiling the human resources development plan.

Strategy*
.........................................................................................................................
.........................................................................................................................
...................

Filled with the strategy to realize the human resources development plan.

Plan for Utilization of Outsourced Labor

Outsourced Labor Utilization Plan Table

No	Field of Work	Reason for Outsourced Labor Utilization	Number of Outsourced Workers	Name of Outsourced Labor Provider Company (if any)	Duration of Agreement with Outsourced Labor Provider Company
1.
2.
3.
...

Reasons and Considerations*
.........................................................................................................................
.........................................................................................................................
...................

Filled with reasons/considerations in compiling the outsourced labor utilization plan.

Strategy*
.........................................................................................................................
.........................................................................................................................
...................

Filled with the strategy to realize the outsourced labor utilization plan.

Information Technology System Development Plan

Information Technology System Utilization Plan Table

No	Type/Name of Application	Ownership (In-house/vendor)	Vendor Name	Application Function
1.
2.
...

Filled with plans for fundamental information technology development and procurement, including: significant changes to information technology configuration or core applications, procurement of new core applications, cooperation with information technology service providers, and/or other fundamental information technology development and procurement that can add and/or increase the Pension Fund's risk. In addition, information regarding information technology development and maintenance costs must be filled in.

Reasons and Considerations*
.........................................................................................................................
.........................................................................................................................
...................

Filled with reasons/considerations in compiling the fundamental information technology development and procurement plan.

Strategy*
.........................................................................................................................
.........................................................................................................................
...................

Filled with the strategy to realize the fundamental information technology development and procurement plan.

Format 11: Report on Plans and Realization of Activities to Enhance Financial Literacy and Inclusion for Consumers and/or the Public

Plan for Activities to Enhance Financial Literacy for Consumers and/or the Public

The format for the Plan and Realization Report on Activities to Enhance Financial Literacy for Consumers and/or the Public as referred to in the Financial Services Authority Regulation regarding the Enhancement of Financial Literacy and Inclusion in the Financial Services Sector for Consumers and/or the Public refers to the format contained in the Appendix of the Financial Services Authority Circular Letter regarding the Implementation of Activities to Enhance Financial Literacy in the Financial Services Sector.

Plan Report on Activities to Enhance Financial Literacy

PLAN REPORT
ON ACTIVITIES TO ENHANCE FINANCIAL LITERACY PERIOD: January to December ... (filled with year) … (filled with financial services business actor name)

No.	Plan Component	Details
1.	Activity Name	…................................ (filled with the name of the activity describing the activity)
2.	Activity Objective	…................................. (filled with the objective of the activity to be achieved by the Financial Services Business Actor)
3.	Form of Implementation	Financial Education<br>☐ Socialization<br>☐ Workshop<br>☐ Consultation<br>☐ Assistance<br>☐ Simulation<br>☐ Training of Community<br>☐ Outreach program<br>☐ Others: … (specify)<br><br>Infrastructure Development<br>☐ Training of trainers<br>☐ Training of facilitators<br>☐ E-learning development<br>☐ Website development<br>☐ Mobile application development<br>☐ Compilation/development of financial education modules/materials<br>☐ Others: … (specify)<br><br>(Mark one of the choices)<br><br>Category<br>☐ New<br>☐ Continuation<br><br>(Mark one of the choices)
4.	Implementation Method and Measurement Method and Means	Implementation Method<br>Direct<br>☐ Face-to-face<br>☐ Live broadcast with means: … (specify)<br>☐ Others: … (specify)<br><br>Measurement Method<br>Financial Education<br>☐ Comparing results before and after activity implementation (pre and post test)<br>☐ Polling for specific segments regarding:<br> ☐ Benefits<br> ☐ Ease of understanding material<br> ☐ Suitability with targets<br> ☐ Others: … (specify)<br>☐ Survey to determine individual/group financial literacy levels<br>☐ Others: … (specify)<br><br>Infrastructure Development<br>Human Resources<br>☐ Comparing results before and after activity implementation (pre and post test)<br>☐ Others: … (specify)<br><br>Non-HR<br>☐ Observation of infrastructure development completion<br>☐ Testing the suitability of infrastructure function development for specific targets<br>☐ Others: … (specify)<br><br>(Can be filled with more than one)<br><br>Means of Measurement<br>☐ Written<br>☐ Electronic Media<br>☐ Online System<br>☐ Others: … (specify)<br><br>Implementation Method<br>Indirect, via media<br>☐ Electronic: … (specify)<br>☐ Print<br>☐ Others: … (specify)<br><br>Measurement Method<br>Financial Education<br>☐ Comparing results before and after activity implementation (pre and post test)<br>☐ Polling for specific segments regarding:<br> ☐ Benefits<br> ☐ Ease of understanding material<br> ☐ Suitability with targets<br> ☐ Others: … (specify)<br>☐ Survey to determine individual/group financial literacy levels<br>☐ Others: … (specify)<br><br>Infrastructure Development<br>Human Resources<br>☐ Comparing results before and after activity implementation (pre and post test)<br>☐ Others: … (specify)<br><br>Non-HR<br>☐ Observation of infrastructure development completion<br>☐ Testing the suitability of infrastructure function development for specific targets<br>☐ Others: … (specify)<br><br>(Can be filled with more than one)<br><br>Means of Measurement<br>☐ Written<br>☐ Electronic Media<br>☐ Online System<br>☐ Others: … (specify)<br><br>Category<br>☐ New<br>☐ Continuation<br><br>(Mark one of the choices)
5.	Material	a. Financial Management, including:<br>☐ Identification of personal/company financial health<br>☐ Financial management objectives<br>☐ Stages in financial management<br>☐ Recording of owned assets/wealth<br>☐ Recording of income and expenses (budgeting), including taxation, identification of income and regular/non-regular monthly/annual expenses<br>☐ Planning programs for future financial goals<br>☐ Others: … (specify)<br><br>b. Types of financial services industry and characteristics of financial services products and/or services<br><br>Types of financial services industry:<br>☐ Banking<br>☐ Capital Market<br>☐ Insurance<br>☐ Pension Funds<br>☐ Financing Institutions<br>☐ Guarantee Institutions<br>☐ Pawnshops<br>☐ Other financial service institutions: … (specify)<br><br>(Can be filled with more than one)<br><br>Characteristics of financial services products and/or services, including:<br>☐ Benefits<br>☐ Costs<br>☐ Risks<br>☐ Consumer rights<br>☐ Consumer obligations<br>☐ How to access or obtain<br>☐ Information on transaction mechanisms<br>☐ Mechanism for handling complaints and dispute resolution<br>☐ Others … (specify)<br><br>c. Taxation<br>☐ Taxation related to financial services products and/or services<br><br>Category<br>☐ New<br>☐ Continuation<br><br>(Mark one of the choices)
6.	Targets	☐ Informal workers<br>☐ Farmers<br>☐ Fishermen<br>☐ Teachers<br>☐ Lecturers<br>☐ Extension workers<br>☐ Professionals: … (specify)<br>☐ Employees

☐ Traders
☐ MSME Actors
☐ Women
☐ Students
☐ University Students
☐ Youth
☐ Pensioners
☐ Indonesian Workers (TKI)
☐ Prospective Indonesian Workers (CTKI) ☐ Families of Indonesian Workers (KTKI) ☐ Persons with Disabilities ☐ Social Welfare Problem Community Groups (PMKS): … (specify) ☐ Communities in lagging, remote, and outermost regions ☐ Communities: … (specify) ☐ General Public ☐ Others: … (specify) (check one option)

Category
☐ New
☐ Continuing (for individual participants/community groups of the same type; does not apply to General Public Targets) (check one option)

Number of Participants
… persons
(to be filled with the number of participants)
Implementation Schedule
: Starts … ends …
(to be filled with the planned date and/or month of implementation)
Implementation Area
Province
☐ Aceh
☐ Bali
☐ Banten
☐ Bengkulu
☐ Gorontalo
☐ DKI Jakarta
☐ Jambi
☐ West Java
☐ Central Java
☐ East Java
☐ West Kalimantan
☐ South Kalimantan
☐ Central Kalimantan
☐ East Kalimantan
☐ North Kalimantan
☐ Bangka Belitung Islands
☐ Riau Islands
☐ Lampung
☐ Maluku
☐ North Maluku
☐ West Nusa Tenggara
☐ East Nusa Tenggara
☐ Papua
☐ West Papua
☐ Riau
☐ West Sulawesi
☐ South Sulawesi
☐ Central Sulawesi
☐ Southeast Sulawesi
☐ North Sulawesi
☐ West Sumatra
☐ South Sumatra
☐ North Sumatra
☐ Special Region of Yogyakarta
☐ Entire Indonesia
(to be filled if implemented domestically and can be filled with more than one)

Regency/City
…
(to be filled if applicable)

Other Areas
…
(to be filled if applicable)

Category
☐ New
☐ Continuing
(check one option)

Implementation Frequency
… times
Cost Source
☐ Financial education budget
☐ CSR budget
☐ Other budget: … (specify)
(check one option)
Cost Amount
(in rupiah)
…
(to be filled with the planned amount of cost allocated for each activity)
Monitoring Parameters:
Financial Education
☐ Suitability of activity format
☐ Suitability of material
☐ Suitability of participant targets
☐ Suitability of participant numbers
☐ Others: … (specify)
(can be filled with more than one)

Human Resource Infrastructure Development ☐ Suitability of activity format ☐ Suitability of material ☐ Suitability of participant targets ☐ Suitability of participant numbers ☐ Others: … (specify)

Non-HR Infrastructure
☐ Suitability of infrastructure development stages ☐ Suitability of implementation of the infrastructure development terms of reference ☐ Others: … (specify) (can be filled with more than one)

Monitoring Format
(referring to monitoring parameters supplemented with monitoring format) ☐ Direct visit ☐ Others: … (specify) (can be filled with more than one)
Evaluation Parameters
Financial Education
☐ Knowledge
☐ Skills
☐ Confidence
☐ Attitude
☐ Behavior
☐ Others: … (specify)
(can be filled with more than one)

Human Resource Infrastructure Development ☐ Ability of trainers/facilitators to deliver teaching material ☐ Others: … (specify)

Non-HR Infrastructure
☐ Availability of infrastructure in the form of: … (specify) ☐ Suitability of infrastructure function with the purpose of infrastructure development ☐ Others: … (specify) (can be filled with more than one)

Evaluation Format
☐ Considering administrative data such as activity reports, implementation documentation, and/or results of interviews with participants and/or activity implementation staff ☐ Considering data and reports from previous periods to know trends and patterns ☐ Conducting success or achievement analysis through comparison between activity planning and realization ☐ Analyzing information regarding the suitability of activities in the context of increasing Financial Literacy with the determined targets ☐ Others: … (specify) (can be filled with more than one)
Remarks
☐ Role of each party in terms of Financial Service Business Entities (PUJK) collaborating with other PUJK:
… (party 1 name)
… (description of party 1's role),
… (party 2 name)
… (description of party 2's role), etc.
☐ Working with other parties:
… (party 1 name)
… (description of party 1's role),
… (party 2 name)
… (description of party 2's role), etc.

Other Information:
Additional information considered necessary to further explain the Financial Literacy activities conducted by the PUJK. ... (description)

Fulfillment of Financial Literacy Principles No. Principle Fulfillment of Principle

Planned and Measurable Automatically filled if PUJK fills table 1 items 3–12 and/or 13–14 and/or 15–16
Achievement-Oriented Automatically filled if PUJK fills table 1 items 2, 6, 7, and 11
Sustainable Automatically filled if PUJK fills Category “Continuing” in one of table 1 items 3, 4, 5, 6, and 9
Collaboration Automatically filled if PUJK fills table 1 item 17 with description of cooperation with PUJK and/or other parties.

Activity Realization Report in the Context of Increasing Financial Literacy
ACTIVITY REALIZATION REPORT
IN THE CONTEXT OF INCREASING FINANCIAL LITERACY PERIOD: January to December ... (filled with year) … (filled with financial service business entity name)

No. Component Realization Remarks

Activity Name
…................................
(to be filled with the activity name describing the activity)
Activity Objective
….................................
(to be filled with the activity objective achieved by the PUJK)
Implementation Format
Financial Education
☐ Socialization
☐ Workshop
☐ Consultation
☐ Assistance
☐ Simulation
☐ Training of Community
☐ Outreach program
☐ Others: … (specify)

Infrastructure Development
☐ Training of trainers
☐ Training of facilitators
☐ E-learning development
☐ Website development
☐ Mobile application development
☐ Compilation/development of Financial Education modules/materials ☐ Others: … (specify) (check one option)

Category
☐ New
☐ Continuing
(check one option)

Implementation Method and Measurement Method and Tools
Implementation Method
Direct
☐ Face-to-face
☐ Live broadcast with tools: … (specify) ☐ Others: … (specify) (can be filled with more than one)

Measurement Method
Financial Education
Tools
☐ Written
☐ Comparing results before and after activity implementation (pre and post test) ☐ Polling for specific segments regarding:
☐ benefits,
☐ ease of material understanding,
☐ suitability with targets,
☐ others:
… (specify)
☐ Survey to determine individual/group financial literacy levels ☐ Electronic media ☐ Online systems ☐ Others:
… (specify)

Infrastructure Development
HR
☐ Comparing results before and after activity implementation (pre and post test) ☐ Others: … (specify)

Non-HR
☐ Observation of infrastructure development completion ☐ Test of infrastructure function suitability for specific targets ☐ Others: … (specify) (can be filled with more than one)

Implementation Method
Indirect, via media
☐ Electronic: … (specify)
☐ Print
☐ Others: … (specify)

Measurement Method
Financial Education
Comparing results before and after activity implementation (pre and post test) ☐ Polling for specific segments regarding:
☐ benefits,
☐ ease of material understanding,
☐ suitability with targets,
☐ others:
… (specify)
☐ Survey to determine individual/group financial literacy levels Tools ☐ Written ☐ Electronic media ☐ Online systems ☐ Others:
… (specify)
(can be filled with more than one)

Infrastructure Development
HR
☐ Comparing results before and after activity implementation (pre and post test) ☐ Others: … (specify)

Non-HR
☐ Observation of infrastructure development completion ☐ Test of infrastructure function suitability for specific targets ☐ Others: … (specify) (can be filled with more than one)

Category
☐ New
☐ Continuing
(check one option)

Material
a. Financial Management, including:
☐ Identification of personal/company financial health ☐ Financial management objectives ☐ Stages in financial management ☐ Recording of owned assets ☐ Recording of income and expenditure (budgeting), including taxation, identification of monthly/annual routine/non-routine income and expenditure ☐ Planning programs for future financial goals ☐ Others: … (specify) (can be filled with more than one)

b. Types of financial service industries and characteristics of financial service products and/or services Types of financial service industries:
☐ Banking
☐ Capital market
☐ Insurance
☐ Pension funds
☐ Financing institutions
☐ Guarantee institutions
☐ Pawnshops
☐ Other financial service institutions: … (specify) (can be filled with more than one)

Characteristics of financial service products and/or services, including:
☐ Benefits
☐ Costs
☐ Risks
☐ Consumer rights
☐ Consumer obligations
☐ How to access or obtain
☐ Transaction mechanism information
☐ Complaint handling and dispute resolution mechanisms ☐ Others … (specify) (can be filled with more than one)

c. Taxation
☐ Taxation related to financial service products and/or services

Category
☐ New
☐ Continuing
(check one option)

Targets
☐ Informal workers
☐ Farmers
☐ Fishermen
☐ Teachers
☐ Lecturers
☐ Extension workers
☐ Professionals: … (specify)
☐ Employees
☐ Traders
☐ MSME Actors
☐ Women
☐ Students
☐ University Students
☐ Youth
☐ Pensioners
☐ Indonesian Workers (TKI)
☐ Prospective Indonesian Workers (CTKI) ☐ Families of Indonesian Workers (KTKI) ☐ Persons with Disabilities ☐ Social Welfare Problem Community Groups (PMKS): … (specify) ☐ Communities in lagging, remote, and outermost regions ☐ Communities: … (specify) ☐ General Public ☐ Others: … (specify) (check one option)

Category
☐ New
☐ Continuing (for individual participants/community groups of the same type; does not apply to General Public Targets) (check one option)

Number of Participants
… persons
(to be filled with the number of participants)
Implementation Schedule
: Starts … ends …
(to be filled with the planned date and/or month of implementation)
Implementation Area
Province
☐ Aceh
☐ Bali
☐ Banten
☐ Bengkulu
☐ Gorontalo
☐ DKI Jakarta
☐ Jambi
☐ West Java
☐ Central Java
☐ East Java
☐ West Kalimantan
☐ South Kalimantan
☐ Central Kalimantan
☐ East Kalimantan
☐ North Kalimantan
☐ Bangka Belitung Islands
☐ Riau Islands
☐ Lampung
☐ Maluku
☐ North Maluku
☐ West Nusa Tenggara
☐ East Nusa Tenggara
☐ Papua
☐ West Papua
☐ Riau
☐ West Sulawesi
☐ South Sulawesi
☐ Central Sulawesi
☐ Southeast Sulawesi
☐ North Sulawesi
☐ West Sumatra
☐ South Sumatra
☐ North Sumatra
☐ Special Region of Yogyakarta
☐ Entire Indonesia
(to be filled if implemented domestically and can be filled with more than one)

Regency/City
…
(to be filled if applicable)

Other Areas
…
(to be filled if applicable)

Category
☐ New
☐ Continuing
(check one option)

Implementation Frequency
… times
Cost Source
☐ Financial education budget
☐ CSR budget
☐ Other budget: … (specify)
(check one option)
Cost Amount
(in rupiah)
…
(to be filled with the realized amount of cost allocated for each activity)
Monitoring Parameters:
Financial Education
☐ Suitability of activity format
☐ Suitability of material
☐ Suitability of participant targets
☐ Suitability of participant numbers
☐ Others: … (specify)
(can be filled with more than one)

Monitoring Format
(referring to monitoring parameters supplemented with monitoring format) ☐ Direct visit ☐ Others: … (specify) (can be filled with more than one)
Evaluation Parameters
Financial Education
☐ Knowledge
☐ Skills
☐ Confidence
☐ Attitude
☐ Behavior
☐ Others: … (specify)
(can be filled with more than one)

Human Resource Infrastructure Development ☐ Ability of trainers/facilitators to deliver teaching material ☐ Others: … (specify)

Evaluation Format
☐ Considering administrative data such as activity reports, implementation documentation, and/or results of interviews with participants and/or activity implementation staff ☐ Considering data and reports from previous periods to know trends and patterns ☐ Conducting success or achievement analysis through comparison between activity planning and realization ☐ Analyzing information regarding the suitability of activities in the context of increasing Financial Literacy with the determined targets ☐ Others: … (specify) (can be filled with more than one)
Measurement Results
(system will refer to the measurement method used supplemented with measurement results) Financial Education ☐ Comparing results before and after activity implementation (pre and post test) ☐ Increased, ...% ☐ Unchanged ☐ Decreased, ...% ☐ ...% results from polling (according to the polling topic conducted) ☐ ...% results from surveys on individual/group Financial Literacy levels (according to the determined group) ☐ ... (filled with other measurement results)

Human Resource Infrastructure Development ☐ Comparing results before and after activity implementation (pre and post test) ☐ Increased, ...% ☐ Unchanged ☐ Decreased, ...% ☐ Others: ...(specify)

Non-HR Infrastructure
☐ ...% infrastructure development completion ☐ ...% results of assessment of specific targets in the test of infrastructure function development suitability ☐ Others: ... (filled with other measurement results)

Monitoring Results
Monitoring Results
(system will refer to monitoring parameters supplemented with adjustment options) ☐ In accordance with plan, ... (description) ☐ Not in accordance with plan, ... (description)
Evaluation Results
... ☐
(description of measurement results linked with analysis of opportunities and challenges of activity implementation)

Evaluation Results
(system will refer to evaluation parameters supplemented with adjustment options) Financial Education ☐ Increased, ... (description) ☐ Unchanged, ... (description) ☐ Decreased, ... (description)

Human Resource Infrastructure Development ☐ Ability of trainers/facilitators to deliver teaching material ☐ Good, ... (description) ☐ Fairly good, ... (description) ☐ Poorly ... (description) ☐ Others: ... (specify)

Non-HR Infrastructure
☐ Infrastructure availability:
☐ Available in the form of: ... (specify) ☐ Not available ☐ Infrastructure function suitability:
☐ Suitable: ... (description)
☐ Not suitable
☐ Others: ... (specify)

Remarks
☐ Role of each party in terms of Financial Service Business Entities (PUJK) collaborating with other PUJK:
… (party 1 name)
… (description of party 1's role),
… (party 2 name)
… (description of party 2's role), etc.
☐ Working with other parties:
… (party 1 name)
… (description of party 1's role),
… (party 2 name)
… (description of party 2's role), etc.

Other Information:
Additional information considered necessary to further explain the Financial Literacy activities conducted by the PUJK. ... (description)

Fulfillment of Financial Literacy Principles No. Principle Fulfillment of Principle

Planned and Measurable Automatically filled if PUJK fills table 1 items 3–12 and/or 13–14 and/or 15–16
Achievement-Oriented Automatically filled if PUJK fills table 1 items 2, 6, 7, and 11
Sustainable Automatically filled if PUJK fills “Continuing” in one of table 1 items 3, 4, 5, 6, and 9
Collaboration Automatically filled if PUJK fills table 1 item 20 with description of cooperation with PUJK and/or other parties.
Plan and Realization of Activities in the Context of Increasing Financial Inclusion for Consumers and/or the Community
The form of the Plan and Realization of Activities in the context of Increasing Financial Inclusion for Consumers and/or the Community as referred to in the Financial Services Authority Regulation regarding the Enhancement of Financial Literacy and Inclusion in the Financial Service Sector for Consumers and/or the Community refers to the form as stated in the Appendix of the Financial Services Authority Circular regarding the Implementation of Activities in the context of Increasing Financial Inclusion in the Financial Service Sector

Activity Plan Report in the Context of Increasing Financial Inclusion
ACTIVITY PLAN REPORT
IN THE CONTEXT OF INCREASING FINANCIAL INCLUSION PERIOD: January to December ... (filled with year) … (filled with financial service business entity name)

No. Component Plan

Activity Scope
☐ Expansion of Access
☐ Provision of financial service products and/or services (check one option)
Activity Name
…
(to be filled with the activity name describing the activity)
Implementation Format
Expansion of Access
☐ Addition of office networks
☐ Addition of cooperation with other parties ☐ Addition of infrastructure that can support the expansion of public financial access: … (specify) ☐ Addition of distribution channels for financial service products and/or services: … (specify) ☐ Facilities for community groups with special needs: … (specify) ☐ Others: … (specify)

Provision of financial service products and/or services ☐ Creation of schemes: … (specify) ☐ Development of financial service products and/or services: … (specify) ☐ Others: … (specify) (check one option)

Category
☐ New
☐ Continuing
(check one option)

Targets
☐ Informal workers
☐ Farmers
☐ Fishermen
☐ Educational institutions
☐ Professionals
☐ Employees
☐ Traders
☐ MSME Actors
☐ Women
☐ Students
☐ Youth
☐ Pensioners
☐ Indonesian Workers (TKI)
☐ Prospective Indonesian Workers (CTKI) ☐ Families of Indonesian Workers (KTKI) ☐ Persons with Disabilities ☐ Social Welfare Problem Community Groups (PMKS): … (specify) ☐ Communities in lagging, remote, and outermost regions ☐ Communities: … (specify) ☐ General Public ☐ Others: … (specify) (check one option)

Category
☐ New
☐ Continuing
(check one option)

Target Users
Number ... users
(to be filled with the number of users)
Schedule
Starts … ends …
(to be filled with the date and/or month of implementation)
Area
Province
☐ Aceh
☐ Bali
☐ Banten
☐ Bengkulu
☐ Gorontalo
☐ DKI Jakarta
☐ Jambi
☐ West Java
☐ Central Java
☐ East Java
☐ West Kalimantan
☐ South Kalimantan
☐ Central Kalimantan
☐ East Kalimantan
☐ North Kalimantan
☐ Bangka Belitung Islands
☐ Riau Islands
☐ Lampung
☐ Maluku
☐ North Maluku
☐ West Nusa Tenggara
☐ East Nusa Tenggara
☐ Papua
☐ West Papua
☐ Riau
☐ West Sulawesi
☐ South Sulawesi
☐ Central Sulawesi
☐ Southeast Sulawesi
☐ North Sulawesi
☐ West Sumatra
☐ South Sumatra
☐ North Sumatra
☐ Special Region of Yogyakarta
☐ Entire Indonesia
(to be filled if implemented domestically and can be filled with more than one)

Regency/City
…
(to be filled if applicable)

Other Areas
…
(to be filled if applicable)

Category
☐ New
☐ Continuing
(check one option)

Parameters
Increase in access to institutions, products and/or financial service services ☐ Addition of office networks ☐ Addition of cooperation with other parties ☐ Addition of infrastructure that can support the expansion of public financial access ☐ Addition of distribution channels for financial service products and/or services ☐ Others: … (specify)

Increase in availability of financial service products and/or services ☐ Addition of types of financial service products and/or services available according to community needs and capabilities across various distribution channels ☐ Others: … (specify)

Increase in usage of financial service products and/or services ☐ Addition of number of savings/credit/financing/securities/pension fund accounts ☐ Addition of number of transactions ☐ Addition of number of insurance policies ☐ Addition of number of guarantee certificates ☐ Addition of number of venture capital business partners/debtors ☐ Addition of number of pawn transactions ☐ Others: … (specify)

Increase in quality of usage of financial service products and services according to community needs and capabilities ☐ Increase in the number of Consumers who not only use similar financial service products and/or services, but also use other financial service products and/or services ☐ Increase in Consumer ability to measure and analyze financial service products and/or services that can encourage increased frequency of utilization of financial service products and/or services and, if needed, able to utilize complaint/dispute resolution services appropriate to the financial management goals to be achieved ☐ Others: … (specify) (can be filled with more than one)

Monitoring Format
Monitoring Format
(referring to monitoring parameters supplemented with monitoring format) ☐ Field ☐ Via reports ☐ Others: … (specify) (can be filled with more than one)

Conducted
(referring to monitoring format)
☐ Monthly
☐ Quarterly
☐ Annually
☐ Other periods: … (specify)
(can be filled with more than one)

Evaluation
☐ Considering administrative data such as activity reports and implementation documentation ☐ Considering data and reports from previous periods ☐ Conducting success or achievement analysis through comparison of planning and realization of activities ☐ Analyzing information regarding the suitability of activities in the context of increasing Financial Inclusion with the determined targets ☐ Others: … (specify) (can be filled with more than one)
Remarks
☐ Role of each party in terms of Financial Service Business Entities (PUJK) collaborating with other PUJK:
… (party 1 name)
… (description of party 1's role),
… (party 2 name)
… (description of party 2's role), etc.
☐ Working with other parties:
… (party 1 name)
… (description of party 1's role),
… (party 2 name)
… (description of party 2's role), etc.
(to be filled if applicable)

Other Information:
Additional information considered necessary to further explain the Financial Literacy activities conducted by the PUJK. ... (description)

Fulfillment of Financial Inclusion Principles No. Principle Fulfillment of Principle

Measurable Automatically filled if PUJK fills table 1 items 5, 8, and 9 and/or 10
Affordable Automatically filled if PUJK fills table 1 items 3 and 8
Targeted Automatically filled if PUJK fills table 1 items 3, 4, and 5
Sustainable Automatically filled if PUJK fills “Category” in table 1 item 3 completely, 4, and 7

Activity Realization Report in the Context of Increasing Financial Inclusion
ACTIVITY REALIZATION REPORT
IN THE CONTEXT OF INCREASING FINANCIAL INCLUSION PERIOD: January to December ... (filled with year)

… (filled with financial service business entity name)

No. Component Plan Remarks

Activity Scope
☐ Expansion of Access
☐ Provision of financial service products and/or services (check one option)
Activity Name
…
(to be filled with the activity name describing the activity)
Implementation Format
Expansion of Access
☐ Addition of office networks
☐ Addition of cooperation with other parties ☐ Addition of infrastructure that can support the expansion of public financial access: … (specify) ☐ Addition of distribution channels for financial service products and/or services: … (specify) ☐ Facilities for community groups with special needs: … (specify) ☐ Others: … (specify)

Category
☐ New
☐ Continuing
(check one option)

Targets
☐ Informal workers
☐ Farmers
☐ Fishermen

☐ Educational Institution
☐ Professional
☐ Employee
☐ Trader
☐ MSME Actors
☐ Women
☐ Students
☐ Youth
☐ Pensioners
☐ Indonesian Migrant Workers (IMW)
☐ Prospective Indonesian Migrant Workers (PIMW) ☐ Family of Indonesian Migrant Workers (FIMW) ☐ Persons with Disabilities ☐ Social Welfare Problem Community Groups (PMKS): … (specify) ☐ Communities in lagging, remote, and outermost regions ☐ Community: … (specify) ☐ General Public ☐ Others: … (specify) (check one option) Category ☐ New ☐ Continuing (check one option)
5. Target
Users
... users
(to be filled with the number of users)
6. Schedule Start … End …
(to be filled with the date and/or month of implementation)
7. Province
☐ Aceh
☐ Bali
☐ Banten
☐ Bengkulu
☐ Gorontalo
☐ DKI Jakarta
☐ Jambi
☐ West Java
☐ Central Java
☐ East Java
☐ West Kalimantan
☐ South Kalimantan
☐ Central Kalimantan
☐ East Kalimantan
☐ North Kalimantan
☐ Bangka Belitung Islands
☐ Riau Islands
☐ Lampung
☐ Maluku
☐ North Maluku
☐ West Nusa Tenggara
☐ East Nusa Tenggara
☐ Papua
☐ West Papua
☐ Riau
☐ West Sulawesi
☐ South Sulawesi
☐ Central Sulawesi
☐ Southeast Sulawesi
☐ North Sulawesi
☐ West Sumatra
☐ South Sumatra
☐ North Sumatra
☐ Special Region of Yogyakarta
☐ All of Indonesia
(to be filled if implemented domestically and can be more than one) Regency/City … (to be filled if applicable) Other Regions … (to be filled if applicable) Category ☐ New ☐ Continuing (check one option)
8. Parameters
Increase in access to institutions, products and/or financial service offerings ☐ Addition of office networks ☐ Addition of cooperation with other parties ☐ Addition of infrastructure that can support the expansion of public financial access ☐ Addition of distribution channels for products and/or financial service offerings ☐ Others: … (specify) Increase in the availability of products and/or financial service offerings ☐ Addition of types of products and/or financial service offerings available according to the needs and abilities of the public on various distribution channels ☐ Others: … (specify) Increase in the use of products and/or financial service offerings ☐ Addition of the number of savings/credit/financing/ equities/pension fund accounts ☐ Addition of the number of transactions ☐ Addition of the number of insurance policies ☐ Addition of the number of guarantee certificates ☐ Addition of the number of business partners and/or venture capital debtors ☐ Addition of the number of pawn transactions ☐ Others: … (specify) Increase in the quality of use of products and financial service offerings according to the needs and abilities of the public ☐ Increase in the number of Consumers who not only use products and/or financial service offerings of the same type, but also use products and/or financial service offerings of other types ☐ Increase in Consumer ability to measure and analyze products and/or financial service offerings that can encourage an increase in the frequency of use of products and/or financial service offerings and, if needed, are able to utilize complaint/dispute resolution services appropriate to the needs of the financial management goals to be achieved ☐ Others: … (specify) (can be filled with more than one)
9. Form
of Monitoring
Form of Monitoring
(referring to monitoring parameters completed with the form of monitoring) ☐ Field ☐ Through reports ☐ Others: … (specify) (can be filled with more than one) conducted (referring to the form of monitoring) ☐ Monthly ☐ Quarterly ☐ Annually ☐ Other periods: … (specify) (can be filled with more than one)
10. Evaluation
☐ Paying attention to administrative data such as activity reports and implementation documentation ☐ Paying attention to data and reports from previous periods ☐ Conducting analysis of success or achievement through comparison of planning and realization of activities ☐ Analyzing information regarding the suitability of activities aimed at increasing Financial Inclusion with the targets that have been determined ☐ Others: … (specify) (can be filled with more than one)
11. Results
of Monitoring and/or
Evaluation
Monitoring Results
(systematically will refer to parameters completed with monitoring results) Increase in access to institutions, products and/or financial service offerings Before After ☐ Number of office networks ...(filled with number) ...(filled with number) ☐ Number of cooperations with other parties ...(filled with number) ...(filled with number) ☐ Addition of infrastructure that can support the expansion of public financial access ...(filled with number) ...(filled with number) ☐ Addition of distribution channels for products and/or financial service offerings ...(filled with number) ...(filled with number) ☐ Others: ... (specify) ...(filled with number/ percentage ) ...(filled with number/ percentage ) Increase in the availability of products and/or financial service offerings Before After ☐ Number of types of products and/or financial service offerings available according to needs and abilities of the public on various distribution channels ...(filled with number) ...(filled with number) ☐ Others: ... (specify) ...(filled with number/ percentage ) ...(filled with number/ percentage ) Increase in the use of products and/or financial service offerings Before After ☐ Addition of savings/cre dit/ financing/ equities/ pension fund accounts ...(filled with number) ...(filled with number) ☐ Addition of the number of transactions ...(filled with number) ...(filled with number) ☐ Addition of the number of policies insurance ...(filled with number) ...(filled with number) ☐ Addition of the number of guarantee certificates ...(filled with number) ...(filled with number) ☐ Addition of the number of business partners and/or venture capital debtors ...(filled with number) ...(filled with number) ☐ Addition of transactions pawn ...(filled with number) ...(filled with number) ☐ Others: ... (specify) ...(filled with number) ...(filled with number) Increase in the quality of use of products and financial service offerings according to the needs and abilities of the public Before After ☐ Increase in the number of Consumers who do not only use products and/or financial service offerings of the same type, but also use products and/or financial service offerings of other types ...(filled with number) ...(filled with number) ☐ Increase in ability of Consumers who can measure and analyze products and/or financial service offerings that can encourage ...(filled with condition) ...(filled with condition) increase in the frequency of use of products and/or financial service offerings and in the event needed able to utilize complaint/dispu te resolution services that are appropriate to the needs of financial management that is desired to be achieved ☐ Others: ... (specify) ...(filled with number/ condition) ...(filled with number/ condition) Evaluation Results ... (description of the analysis of monitoring results linked to opportunities and challenges in implementing activities)
12. Notes
☐ The role of each party in
PUJK collaborating with other PUJK:

… (name of party 1)
… (description of party 1's role),
… (name of party 2)
… (description of party 2's role), etc.
☐ Cooperating with other parties:
… (name of party 1)
… (description of party 1's role),
… (name of party 2)
… (description of party 2's role), etc.
Other Information:
Additional information considered necessary to further explain the Financial Literacy activities conducted by PUJK. ... (description) Fulfillment of Financial Inclusion Principles No Principle Fulfillment of Principle
Measurable Automatically filled if PUJK fills table 1
numbers 5, 8, and/or 9 and/or 10
Affordable Automatically filled if PUJK fills table 1
numbers 3 and 8
Targeted Automatically filled if PUJK fills table 1
numbers 3, 4, and 5
Sustainable Automatically filled if PUJK fills the “Category”
in table 1 number 3 completely, 4, and 7 Format 12: Financial Statement Projections
Projection of Net Asset Statement for Pension Funds
(in full rupiah units)
DESCRIPTION
Actual as of Sep 30
20XX-1
Projection as of Dec 31
20XX-1 as of Jun 30
20XX as of Dec 31
20XX
ASSETS
INVESTMENTS
Bank Savings

DESCRIPTION
Actual as of Sep 30
20XX-1
Projection as of Dec 31
20XX-1 as of Jun 30
20XX as of Dec 31
20XX
Call Deposits at
Banks
Time Deposits at Banks
Certificates of Deposit at Banks
Securities issued by
Bank Indonesia
Government Securities
Stocks listed on the
Indonesian Stock Exchange
Corporate Bonds listed on the
Indonesian Stock Exchange
Corporate Sukuk
Listed on the
Indonesian Stock Exchange
Regional Bonds/Sukuk
Mutual Funds
MTN
Asset-Backed Securities
Real estate investment funds in the form of collective investment contracts Infrastructure investment funds in the form of collective investment contracts Option contracts and equity forward contracts listed on the Indonesian Stock Exchange REPO Direct Participation Land in Indonesia

DESCRIPTION
Actual as of Sep 30
20XX-1
Projection as of Dec 31
20XX-1 as of Jun 30
20XX as of Dec 31
20XX
Buildings in
Indonesia
Land and Buildings in Indonesia
TOTAL INVESTMENTS
CURRENT ASSETS OUTSIDE
INVESTMENTS
Cash and Bank
Prepaid Expenses
Investment Receivables
Investment Income Receivables
Other Receivables
TOTAL CURRENT ASSETS
OUTSIDE INVESTMENTS
AVAILABLE ASSETS
LIABILITIES
Liabilities outside Pension Benefit
Liabilities
Pension Benefit and Other
Benefits Payable Due
Voluntary Benefit Payable
Investment Payable
Unearned Revenue
Expenses Still to Be Paid
Other Payables
Total Liabilities outside
Pension Benefit Liabilities

-
TOTAL LIABILITIES - -
NET ASSETS
Notes:

If the business plan submission is for the year 2020, then 20XX-1
is the year 2019 (current year), 20XX is the year 2020, etc.
The Net Asset Nominal is equal to the Net Asset Nominal at the End of the Period in the Projection of the Statement of Changes in Net Assets.
The Net Asset Nominal at the End of the Period is equal to the Net Assets in the Projection of the Net Asset Statement.

Projection of Statement of Changes in Net Assets
(in full rupiah units)
DESCRIPTION
Actual as of Sept
30
20XX-1
Projection as of Dec 31
20XX-1 as of Jun 30
20XX as of Dec 31
20XX
ADDITIONS
Investment Income
Interest/Profit Sharing -
Dividends -
Rent -
Gain (Loss) on Investment Disposal

Other Investment Income

Total Investment Income
Increase
(Decrease) in Investment Value
Contributions
Income Outside
Investment
Transfer of Funds From
Other Pension Funds
Total Additions
DEDUCTIONS
Investment Expenses
Operational Expenses
Expenses Outside Investment and Operations Pension Benefits and Other Benefits Income Tax Transfer of Funds to Other Pension Funds Contribution Withdrawals Total Deductions

DESCRIPTION
Actual as of Sept
30
20XX-1
Projection as of Dec 31
20XX-1 as of Jun 30
20XX as of Dec 31
20XX
INCREASE (DECREASE)
IN NET ASSETS
NET ASSETS AT THE
BEGINNING OF THE PERIOD
NET ASSETS AT THE
END OF THE PERIOD
Notes:

If the business plan submission is for the year 2020, then 20XX-1
is the year 2019 (current year), 20XX is the year 2020, etc.
The Net Asset Nominal at the End of the Period is equal to the Net Assets in the Projection of the Net Asset Statement
Format 13: Projection of Ratios and Other Specific Items, and Assumptions Used

Ratios and other specific items
(ratios in percentage)
DESCRIPTION
Actual as of Sept
30 20XX-1
Projection as of Dec
31
20XX-1 as of Jun
30
20XX as of Dec
31
20XX
Investment Income Ratio
(ROI)
Investment Income Ratio against Assets (ROA) Operational Expense Ratio (BOPO) Notes:

If the business plan submission is for the year 2020, then 20XX-1
is the year 2019 (current year), 20XX is the year 2020, etc.

Assumptions Used
No DESCRIPTION Actual as of Sept
30 20XX-1
Projection as of Dec 31
20XX-1 as of Jun
30
20XX as of Dec
31
20XX
Rupiah exchange rate
Inflation rate

Notes:

If the business plan submission is for the year 2020, then 20XX-1
is the year 2019 (current year), 20XX is the year 2020, etc. Format 14: Other Information

Investment return rate
etc. (other relevant assumptions)
Other information must at least include information that needs to be submitted because it affects the business activities of the Pension Fund, which are not mentioned in the scope of the Business Plan. Example:
a. dissolution plan; b. membership transfer plan;
c. plan to change business activities from non-Sharia principles to
Sharia principles; and d. Sustainable Finance Action Plan based on POJK regarding the Implementation of Sustainable Finance for Financial Service Institutions, Issuers, and Public Companies.

F. Pension Fund Business Plan Implementation Report Business Plan Implementation Report in accordance with the provisions of Article 14 paragraph (5) of POJK Number 24/POJK.05/2019 concerning Business Plans for Non-Bank Financial Service Institutions with a submission deadline no later than 1 (one) month after the relevant semester ends. BUSINESS PLAN IMPLEMENTATION REPORT
Year ...............................
(to be filled with the name and address of the Pension Fund) Approved by, Board of Supervisors (Pension Fund Stamp) Full Name Position , 20xx Management, (Pension Fund Stamp) Full Name Position

Explanation Regarding Business Plan Achievement
Filled with an explanation regarding the achievement of the Business Plan, including the achievement of the Business Plan and the comparison of plans and realization, which must at least include:
realization of business activity plans as referred to in Format
5 in the pension fund business plan;
realization of business activity development or expansion plans
as referred to in Format 6 in the pension fund business plan;
realization of investment plans as referred to in Format 7 in the
pension fund business plan;
realization of financing plans as referred to in Format 8
in the pension fund business plan;
realization of office network or distribution channel development
and/or changes as referred to in Format 9 in the pension fund business plan;
realization of organizational, human resources,
and/or information technology development as referred to in Format 10 in the pension fund business plan;
realization of financial statement projections, as referred to in
Format 12 in the pension fund business plan;
realization of projections of ratios and other specific items, and assumptions
used as referred to in Format 13 in the business plan; and
filling out the business plan based on the business plan report
submitted to the OJK most recently
Explanation Regarding Deviations from Business Plan Realization

Realization of Net Asset Statement for Pension Funds
(in full rupiah units)
DESCRIPTION
Business Plan
(1)
Realization
(2)
Achievement
% (2)/(1)
ASSETS
INVESTMENTS
Bank Savings
Call Deposits at
Banks
Time Deposits at
Banks
Certificates of Deposit at
Banks
Securities issued by
Bank Indonesia
Government Securities

(in full rupiah units)
DESCRIPTION
Business Plan
(1)
Realization
(2)
Achievement
% (2)/(1)
Stocks listed on the
Indonesian Stock Exchange
Corporate Bonds listed on the
Indonesian Stock Exchange
Corporate Sukuk listed on the
Indonesian Stock Exchange
Regional Bonds/Sukuk
Mutual Funds
MTN
Asset-Backed Securities
Real estate investment funds in the form of collective investment contracts Infrastructure investment funds in the form of collective investment contracts Option contracts and equity forward contracts listed on the Indonesian Stock Exchange REPO Direct Participation Land in Indonesia Buildings in Indonesia Land and Buildings in Indonesia TOTAL INVESTMENTS CURRENT ASSETS OUTSIDE INVESTMENTS Cash and Bank Prepaid Expenses Investment Receivables Investment Income Receivables Other Receivables TOTAL CURRENT ASSETS OUTSIDE INVESTMENTS AVAILABLE ASSETS

(in full rupiah units)
DESCRIPTION
Business Plan
(1)
Realization
(2)
Achievement
% (2)/(1)
LIABILITIES
Liabilities Outside
Pension Benefit
Liabilities
Pension Benefit and Other Benefits Payable Due Voluntary Benefit Payable Investment Payable Unearned Revenue Expenses Still to Be Paid Other Payables Total Liabilities Outside Pension Benefit Liabilities TOTAL LIABILITIES NET ASSETS
2) Realization of Statement of Changes in Net Assets
(in full rupiah units)
DESCRIPTION
Business Plan
(1)
Realization
(2)
Achievement
% (2)/(1)
ADDITIONS
Investment Income
Interest/Profit Sharing
Dividends
Rent
Gain (Loss) on Investment Disposal
Other Investment Income
Total Investment Income

Realization of Assumptions Used
Increase (Decrease) in Investment Value Contributions Income Outside Investment Transfer of Funds From Other Pension Funds Total Additions DEDUCTIONS Investment Expenses Operational Expenses Expenses Outside Investment and Operations Pension Benefits and Other Benefits Income Tax Transfer of Funds to Other Pension Funds Contribution Withdrawals Total Deductions INCREASE (DECREASE) IN NET ASSETS NET ASSETS AT THE BEGINNING OF THE PERIOD NET ASSETS AT THE END OF THE PERIOD No DESCRIPTION Business Plan (1) Realization (2) Deviation (2)-(1)

Rupiah exchange rate
Inflation rate
Investment return rate
etc. (other relevant assumptions)

Realization of Ratios and Other Specific Items
DESCRIPTION
Business Plan
(1)
Realization
(2)
Achievement % (2)/(1)
Investment Income Ratio
(ROI)
Investment Income Ratio against Assets (ROA) Operational Expense Ratio (BOPO) Financing Ratio Solvency Ratio

Other Information
...............................................................................................................................
...............................................................................................................................
...............................................................................................................................
...............................................................................................................................
...............................................................................................................................
.............................................................

Filled with an explanation regarding the achievement of other information in the Business Plan
and the comparison of plans and realization.

Follow-up on Business Plan Achievement
....................................................................................................................
....................................................................................................................
..................................................

G. Business Plan Supervision Report
Business Plan Supervision Report in accordance with the provisions of Article 15 paragraph (1) of POJK Number 24/POJK.05/2019 concerning Business Plans for Non-Bank Financial Service Institutions with a submission deadline no later than 1 (one) month after the relevant semester ends. BUSINESS PLAN SUPERVISION REPORT
Year ...............................
(to be filled with the name and address of the Pension Fund) , 20xx Board of Supervisors (Pension Fund Stamp) Full Name Position

H. Report on Data Updating Activities Plan and Realization Report on Customer Data Updating as Referred to in the Financial Services Authority Regulation Regarding the Implementation of the Anti-Money Laundering and Counter-Terrorism Financing Program in the Financial Service Sector
I. Proof of Announcement of Annual Financial Statements Audited by Public Accountants on the DPLK Website and/or Daily Newspapers in Indonesian Circulated Nationally
Determined in Jakarta on January 21, 2021 EXECUTIVE HEAD OF SUPERVISOR FOR INSURANCE, PENSION FUNDS, LENDING INSTITUTIONS, AND OTHER FINANCIAL SERVICE INSTITUTIONS FINANCIAL SERVICES AUTHORITY REPUBLIC OF INDONESIA, sd RISWINANDI
.................................................................................................................................
.................................................................................................................................
.................................................................................................................................
..........................................................................................
(to be filled with the Board of Supervisors' assessment of the implementation of the Business Plan in the form of an assessment of quantitative and qualitative aspects of the realization of the Business Plan, including an assessment of good corporate governance factors for Pension Funds, risk profile, profitability, and financing, as well as efforts to improve the performance of the Pension Fund, if according to the assessment the Pension Fund's performance shows a decline. This copy is in accordance with the original Legal Director 1 Legal Department sd Mufli Asmawidjaja

Form and Structure of Periodic Reports for Pension Funds

ASSETS

INVESTMENT ASSETS (Historical Value)

CURRENT ASSETS EXCLUDING INVESTMENTS

OPERATIONAL ASSETS

OTHER ASSETS

LIABILITIES

PENSION BENEFIT LIABILITIES

LIABILITIES EXCLUDING PENSION BENEFIT LIABILITIES

ASSETS

INVESTMENTS (Historical Value)

INVESTMENT VALUATION DIFFERENCE

CURRENT ASSETS EXCLUDING INVESTMENTS

TOTAL CURRENT ASSETS EXCLUDING INVESTMENTS

TOTAL ASSETS

LIABILITIES

PENSION BENEFIT LIABILITIES

TOTAL PENSION BENEFIT LIABILITIES

LIABILITIES EXCLUDING PENSION BENEFIT LIABILITIES

TOTAL LIABILITIES EXCLUDING PENSION BENEFIT LIABILITIES

TOTAL LIABILITIES

DEFINED CONTRIBUTION PENSION PROGRAM

BALANCE SHEET

Other Benefit Pension Program

Other Benefit Pension Program

INVESTMENT INCOME

INVESTMENT EXPENSES

INVESTMENT RESULTS

OPERATIONAL EXPENSES

OTHER INCOME AND EXPENSES

PRE-TAX OPERATING RESULTS

INCOME TAX

AFTER-TAX OPERATING RESULTS

DEFINED CONTRIBUTION PENSION PROGRAM

STATEMENT OF COMPREHENSIVE INCOME

Other Benefit Pension Program

CASH FLOWS FROM INVESTMENT ACTIVITIES

CASH FLOWS FROM OPERATIONAL ACTIVITIES

CASH FLOWS FROM FINANCING ACTIVITIES

INCREASE (DECREASE) IN NET CASH

CASH AT BEGINNING OF PERIOD

CASH AT END OF PERIOD

DEFINED CONTRIBUTION PENSION PROGRAM

STATEMENT OF CASH FLOWS

PENSION FUND PARTICIPATION

Other Benefit Program

Total

INVESTMENT RECAPITULATION

DEFINED CONTRIBUTION PENSION PROGRAM

INVESTMENT INCOME STATEMENT

DEFINED CONTRIBUTION PENSION PROGRAM

OTHER BENEFIT INVESTMENT INCOME STATEMENT

DEFINED CONTRIBUTION PENSION PROGRAM

ASSET AND LIABILITY RECAPITULATION

Investment Details with a Single Counterparty

Investment Limits in Directives

Investment Limits According to Regulations

Investment Details with Affiliated Parties

Investment Type | Amount | Percentage of Total Investment

Details of Identified Problematic Investments

Investment Income Ratio (ROI)

Investment Income to Assets Ratio (ROA)

Operational Expense Ratio (BOPO)

Contribution Receivable Age Ratio (RUPI)

Investment to Net Assets Ratio (RITA)

Investment Receivables and Investment Income Receivables to Total Investments

Investment Growth Ratio

Market Price Changes in Pension Fund Assets

SPI compared to Total Income

SPI compared to Net Assets

Minimum Liquidity Ratio / Cash Ratio

Cash Inflows compared to Cash Outflows

Contribution Receivable Ratio to Net Assets

Growth Ratio of Founder Contribution Receivables (Employer Contributions + Additional Contributions)

Ratio of Total Long-Term Assets to Total Long-Term Liabilities

Income to Expenditure Ratio

Interest Rate Spread

Ratio of Current Assets to Total Assets

Ratio of Current Liabilities to Total Liabilities

Operating Expense Ratio