Form and Structure of Periodic Reports for Pension Funds

To:

Management of Employer Pension Funds; and
Management of Financial Institution Pension Funds,
At their respective locations.

COPY

CIRCULAR LETTER OF THE FINANCIAL SERVICES AUTHORITY NUMBER 3 /SEOJK.05/2019

CONCERNING

FORM AND STRUCTURE OF PERIODIC REPORTS FOR PENSION FUNDS

In relation to the mandate of Article 13 and Article 14 paragraph (3) of Financial Services Authority Regulation Number 5/POJK.05/2018 concerning Periodic Reports for 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 regarding the form, structure, and method of submission of periodic reports for 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, including Pension Funds that conduct all or part of their business using Sharia principles.
Employer Pension Fund, hereinafter abbreviated as DPPK, is a Pension Fund established by a person or entity that employs employees, as the founder, to run 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 run a defined contribution pension program for individuals, whether employees or self-employed workers, who are separate from the DPPK for employees of the respective bank or life insurance company.
Periodic Report is a report compiled by the Pension Fund for the benefit of the Financial Services Authority for a specific period.
Monthly Report is a report compiled by the Pension Fund for the benefit of the Financial Services Authority, covering the period from January 1 to the end of the relevant month.
Annual Report is a report compiled by the Pension Fund for the benefit of the Financial Services Authority, covering the period from January 1 to the end of the relevant year.
Other Report is a report compiled by the Pension Fund for the benefit of the Financial Services Authority other than Monthly Reports and Annual Reports, submitted during a specific period.

II. FORM AND STRUCTURE OF PERIODIC REPORTS FOR PENSION FUNDS

Periodic Reports for Pension Funds consist of:
a. Monthly Report; b. Annual Report; and
c. Other Report.
The Annual Report as referred to in item 1 letter b for Pension Funds consists of:
a. annual financial report; and b. technical report.
The annual financial report as referred to in item 2 letter a consists of:
a. annual financial report audited by a public accountant; and b. electronic data.
The annual financial report audited by a public accountant as referred to in item 3 letter a follows 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 the Monthly Report as referred to in item 1 letter a and the annual financial report in the form of electronic data as referred to in item 3 letter b, for DPPK conducting defined benefit pension programs, are as contained in Format IA; b. the form and structure of the Monthly Report as referred to in item 1 letter a and the annual financial report in the form of electronic data as referred to in item 3 letter b, for DPPK conducting defined contribution pension programs, are as contained in Format IB;
c. the form and structure of the technical report 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 the Monthly Report as referred to in item 1 letter a and the annual financial report in the form of electronic data as referred to in item 3 letter b are as contained in Format IIA; b. the form and structure of the technical report 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. METHOD OF SUBMISSION OF PERIODIC REPORTS

Submission of Periodic Reports is conducted online 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, experiences technical problems, or experiences force majeure, the Pension Fund must submit Periodic Reports online via email to the Financial Services Authority.
In order to submit online via email as referred to in item 2, the Pension Fund must submit in writing to the Financial Services Authority the email address of the Pension Fund used for the submission of Periodic Reports to the Financial Services Authority.
The Pension Fund submits Periodic Reports offline, in the event that submission online via email as referred to in item 2 cannot be done due to technical problems or force majeure.
Submission of Periodic Reports offline is done with written notification accompanied by supporting documents in the form of Periodic Reports either using media in the form of compact disc (CD) or other electronic data storage media, and sent to the Financial Services Authority via a letter signed by the management, and addressed to:
Financial Services Authority attn. Director of Pension Fund and Manpower Social Security Supervision Wisma Mulia 2 Building, 12th Floor Jalan Jenderal Gatot Subroto Number 42 Jakarta 12710.
Submission of Periodic Reports offline as referred to in item 5 is done in one of the following ways:
a. handed over directly; 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 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
proof of email delivery for reports sent to the Financial Services Authority's email address, in the event that delivery via the data communication network cannot be done; or
b. for submission offline, proven by:
a receipt letter from the Financial Services Authority, if the report is handed over directly; or
a shipping receipt from the courier service company, if the report is sent through a courier service company.

IV. CLOSING PROVISIONS

The provisions in this Financial Services Authority Circular Letter shall take effect on May 1, 2019.
At the time this Financial Services Authority Circular Letter takes effect:
a. Regulation of the Chairman of the Capital Market Supervisory Board and Financial Institutions Number PER-05/BL/2012 concerning the Compilation of Financial Reports and Investment Valuation Basis for Pension Funds; b. Financial Services Authority Circular Letter Number 5/SEOJK.05/2013 concerning Monthly Reports for Pension Funds;
c. Appendix II in Financial Services Authority Circular Letter Number 2/SEOJK.05/2015 concerning Pension Fund Risk Level Assessment;
d. Appendix III in Financial Services Authority Circular Letter Number 2/SEOJK.05/2015 concerning Pension Fund Risk Level Assessment; e. Annex III in Financial Services Authority Circular Letter Number 9/SEOJK.05/2016 concerning Investment Valuation Basis for Pension Funds, Form and Structure and Method of Submission of Annual Investment Reports for Pension Funds; f. Annex IV in Financial Services Authority Circular Letter Number 9/SEOJK.05/2016 concerning Investment Valuation Basis for Pension Funds, Form and Structure and Method of Submission of Annual Investment Reports for Pension Funds; g. Appendix VI in Financial Services Authority Circular Letter Number 10/SEOJK.05/2016 concerning Guidelines for the Implementation of Risk Management and Self-Assessment Report Results of Risk Management Implementation for Non-Bank Financial Service Institutions; and h. Financial Services Authority Circular Letter Number 11/SEOJK.05/2016 concerning the Form and Structure of Technical Reports for Pension Funds, are revoked and declared invalid.

Determined in Jakarta on March 5, 2019

EXECUTIVE HEAD OF SUPERVISOR
OF INSURANCE, PENSION FUNDS,
LENDING INSTITUTIONS, AND
OTHER FINANCIAL SERVICE INSTITUTIONS FINANCIAL SERVICES AUTHORITY, signed RISWINANDI

This copy is in accordance with the original Director of Law 1 Law Department signed Yuliana

APPENDIX I
CIRCULAR LETTER OF THE FINANCIAL SERVICES AUTHORITY NUMBER 3 /SEOJK.05/2019 CONCERNING FORM AND STRUCTURE OF PERIODIC REPORTS FOR PENSION FUNDS

FORMAT IA
To
Yth. Directorate of Statistics and Information IKNB Financial Services Authority

MONTHLY REPORT / ANNUAL FINANCIAL 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 Compiler Officer Name Division Telephone Fax Email Management Person in Charge Person in Charge Name Position Telephone Fax E-mail Pension Fund Address

Description Details
Code
Percentage
Defined Benefit Pension Program Other Combined Benefits ASSETS INVESTMENTS Bank Savings 1101 On-call Deposits at Banks 1102 Term Deposits at Banks 1103 Bank Deposit Certificates 1104 Securities issued by Bank Indonesia 1105 Government Securities 1106 Shares listed on the Indonesian Stock Exchange 1107 Corporate Bonds listed on the Indonesian stock exchange 1108 Corporate Sukuk Listed on the Indonesian 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 Indonesian 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 1202

Employer Normal Contribution
Participant Normal Contribution
Participant Voluntary Contribution
Additional Contributions
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 Benefits and Other Benefits 1501 Voluntary Benefit 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 ASSET REPORT Per DD-MM-YYYY

Other Combined Benefits Program
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

Employer Normal Contribution
Participant Normal Contribution
Participant Voluntary Contribution
Additional Contributions
Income Outside Investment 403
Transfer of Funds from Other Pension Funds 404 Total Additions DEDUCTIONS 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 Total Deductions INCREASE (DECREASE) IN NET ASSETS NET ASSETS AT BEGINNING OF PERIOD NET ASSETS AT END OF PERIOD Details Code DEFINED BENEFIT PENSION PROGRAM NET ASSET CHANGE REPORT Per DD-MM-YYYY Description Accumulated to DD-MM-YYYY

Other Combined Benefits Program
ASSETS
INVESTMENTS (Historical Value)
Bank Savings
On-call Deposits at Banks
Term Deposits at Banks
Bank Deposit Certificates
Securities issued by Bank Indonesia Government Securities Shares 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 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 Indonesian 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 OUTSIDE INVESTMENTS Cash and Bank Contribution Receivables

Employer Normal Contribution
Participant Normal Contribution
Participant Voluntary Contribution
Additional Contributions
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 ACTUARIAL PRESENT VALUE DIFFERENCE LIABILITIES OUTSIDE ACTUARIAL PRESENT VALUE Due Pension Benefits and Other Benefits Voluntary Benefit 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 Accumulated to DD-MM-YYYY

Other Combined Benefits 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 Expenses Custody Expenses Other Investment Expenses Total Investment Expenses INVESTMENT BUSINESS RESULTS OPERATIONAL EXPENSES Employee, Management, and Supervisory Board Salaries/Honoraria Office Expenses Maintenance Expenses Depreciation Expenses Third-Party Service Expenses Other Operational Expenses Total Operational Expenses OTHER INCOME AND EXPENSES Late Contribution Interest Gain (Loss) on Sale of Operational Assets Gain (Loss) on Sale of Other Assets Other Income Outside Investment Other Expenses Outside Investment and Operations Total Other Income and Expenses INCOME BEFORE TAX INCOME TAX INCOME AFTER TAX DEFINED BENEFIT PENSION PROGRAM INCOME STATEMENT REPORT Per DD-MM-YYYY Description Accumulated to DD-MM-YYYY

Other Combined Benefits Program
CASH FLOW FROM INVESTMENT ACTIVITIES Receipt of Interest/Profit Sharing Receipt of Dividends Receipt of Rent Other Investment Income Investment Disposal Investment Investment Payment of Investment Expenses Net Cash 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 Income Outside Investment Other Expenses Outside Investment and Operations Income Tax Net Cash from Operational Activities CASH FLOW FROM FINANCING ACTIVITIES Receipt of Employer Normal Contributions Receipt of Participant Normal Contributions Receipt of Participant Voluntary Contributions Receipt of Additional Contributions 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 and Other Benefits Net Cash 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 REPORT Per DD-MM-YYYY Accumulated to DD-MM-YYYY

Children
Deferred Pensions
(3) Total DPPK Participants (1) + (2)
Widows/Widowers
Children
Deferred Pensions
b. Founder Partners
Pensioners
Widows/Widowers
Total
PENSION FUND PARTICIPATION
Per DD-MM-YYYY
Pensioners
Description Other Pension Program Benefits (1) Active Participants a. Founder b. Founder Partners (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 Per DD-MM-YYYY Total Total Deductions Funding Value Funding Wealth Description Deductions Total Total Wealth in court dispute, or controlled or seized by competent authorities Contributions, which on the actuarial valuation date have not been paid for more than 3 (three) months since the due date Total

Bank Savings
On-call Deposits at Banks
Term Deposits at Banks
Bank Deposit Certificates
Securities issued by Bank Indonesia Government Securities Shares 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 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 Indonesian Stock Exchange REPO Direct Participation Land in Indonesia Buildings in Indonesia Land and Buildings in Indonesia TOTAL INVESTMENTS Dec DEFINED BENEFIT PENSION PROGRAM Sep Oct INVESTMENT RECAP Per DD-MM-YYYY May Jun Jul Aug Description Jan Feb Mar Apr Nov

Interest/Profit Sharing Dividends Rent Gain/Loss Disposal Others Bank Savings On-call Deposits at Banks Term Deposits at Banks Bank Deposit Certificates Securities issued by Bank Indonesia Government Securities Shares listed on the Indonesian Stock Exchange Corporate Bonds listed on the Indonesian stock exchange Sukuk 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 Indonesian Stock Exchange REPO Direct Participation Land in Indonesia Buildings in Indonesia Land and Buildings in Indonesia Total DEFINED BENEFIT PENSION PROGRAM INVESTMENT INCOME REPORT Per DD-MM-YYYY Investment Type Realized Investment Income ROI Average Investment Net Investment Income Investment Expenses Unrealized Investment Income

Interest/Profit Sharing Dividends Rent Gain/Loss Disposal Others Bank Savings On-call Deposits at Banks Term Deposits at Banks Bank Deposit Certificates Securities issued by Bank Indonesia Government Securities Shares listed on the Indonesian Stock Exchange Corporate Bonds listed on the Indonesian stock exchange Sukuk 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 Indonesian Stock Exchange REPO Direct Participation Land in Indonesia Buildings in Indonesia Land and Buildings in Indonesia Total DEFINED BENEFIT PENSION PROGRAM OTHER BENEFITS INVESTMENT INCOME REPORT Per DD-MM-YYYY Investment Type Realized Investment Income Unrealized Investment Income Investment Expenses Net Investment Income 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 Term Deposits at Banks Bank Deposit Certificates Securities issued by Bank Indonesia Government Securities Shares 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 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 Indonesian Stock Exchange REPO Direct Participation Land in Indonesia Buildings in Indonesia Land and Buildings in Indonesia Total Investments B. Current Assets Outside Investment Cash and Bank Contribution Receivables Employer Normal Contribution Participant Normal Contribution Participant Voluntary Contribution Additional Contributions Interest Receivable on Late Contributions Prepaid Expenses Investment Receivables Investment Income Receivables Other Receivables Total Current Assets Outside Investment
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 Benefits and Other Benefits Voluntary Benefit 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. Percentage (%) Fund 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 years <= Due < 10 years

Type Quantity Percentage Against Total Investment ab c d e f g … Details of Investment in One Party Investment No. Counterparty Name Limitation In Investment Guidelines Investment Limitation In Accordance with Regulations Per DD-MM-YYYY

Name Type
Investment
Balance Name Type
Investment
Security Series Ownership Type Rating Balance Name Type Investment Investment Manager Fair Value % Government Securities in Mutual Funds Balance Name Type Investment Investment Manager Recipient Entity/Project Balance Name Type Investment Security Series Ownership Type Rating Balance Name Type Investment Balance … Total DETAILS OF COMPLIANCE WITH PROVISIONS REGARDING GOVERNMENT SECURITIES INVESTMENTS Government Securities Bonds / Sukuk Infrastructure Mutual Funds Underlying Government Securities Mutual Funds Limited Participation Asset-Backed Securities Other Investments for Government Infrastructure Project Financing No.

Investment Income Ratio (ROI)
A. Investment Income after deducting investment operational expenses B. Average Investment
C. Ratio (a:b)
Investment Income Ratio Against Assets (ROA) A. Investment Income + Other Income - Investment and Non-Investment Expenses B. Total Available Assets
C. Ratio (a:b)
Operational Expense Ratio (BOPO)
A. Operational Expenses
B. Total Available Assets
C. Ratio (a:b)
Total Other Benefits Pension Program FINANCIAL RATIOS Per DD-MM-YYYY Description

No. Investment Manager Name Investment Manager Number Contract Date Contract Date Contract Period Investment Type Fund Managed Amount (Rp) Net Investment Return (Rp) Management Fees Charged (Rp) Affiliated with Pension Fund (Yes/No) 1. 2.
3. etc
1.
2.
3. etc
1.
2.
3. etc
1.
2.
3. etc
*: if using an Investment Manager
Total etc.

Format for Disclosure of Investment Manager* Pension Fund ….. Use of Investment Manager Per DD-MM-YYYY

ab c d e f g h
…
Total

DETAILS OF SAVINGS
Duration Interest Rate/Profit Sharing Remarks Bank Name Acquisition Date No. Nominal Value Pension Program/ Other Benefits

ab c d e f g h
…
Total
Nominal Value Duration Interest Rate/Profit Sharing

DETAILS OF ON-CALL DEPOSITS
No. Bank Name Acquisition Date Remarks Pension Program/ Other Benefits

ab c d e f g h
…
Total
Nominal Value Duration Interest Rate/Profit Sharing

DETAILS OF TIME DEPOSITS
No. Bank Name Acquisition Date Remarks Pension Program/ Other Benefits

ab c d e f g h
…
Total
Nominal Value Duration Interest Rate/Profit Sharing

DETAILS OF CERTIFICATES OF DEPOSIT No. Bank Name Acquisition Date Remarks Pension Program/ Other Benefits

Nominal Value % ab c d e f g h i j k l … Total Remarks Fair Value Acquisition Value Investment Valuation Difference

DETAILS OF INDONESIA BANK CERTIFICATES No.
Securities Code
Acquisition Date Nominal Value Coupon (%) Maturity Date Pension Program/ Other Benefits

Nominal Value % ab c d e f g h i j k l m … Total Remarks Investment Valuation Difference

DETAILS OF GOVERNMENT SECURITIES No. Securities Code Acquisition Date Nominal Value Coupon (%) Maturity Date Acquisition Value Fair Value Accounting Method Pension Program/ Other Benefits

Nominal Value % ab c d e f g h i j k l … Total Investment Valuation Difference

DETAILS OF SHARES
No. Share Code Issuer / Issuer Name Acquisition Date Number of Shares Economic Sector Remarks Acquisition Value Market Value Pension Program/ Other Benefits

Beginning End Value % ab c d e f g h i j k l m n o p q r … Total

DETAILS OF CORPORATE BONDS
Remarks No. Bond Code Bond Name Coupon (%) Maturity Date Rating Nominal Value Acquisition Value Fair Value Investment Valuation Difference Issuer Name Acquisition Date Economic Sector Accounting Method Pension Program/ Other Benefits

Economic Sector
Beginning End Value % ab c d e f g h i j k l m n o p q r … Total Remarks Acquisition Value Fair Value Investment Valuation Difference

DETAILS OF SUKUK
No. Issuer Name Sukuk Code Sukuk Name Acquisition Date Nominal Value Coupon (%) Maturity Date Rating Accounting Method Pension Program/ Other Benefits

Beginning End Value % ab c d e f g h i j k l m n o p q r … Total

DETAILS OF REGIONAL BONDS/SUKUK No. Issuer Name Regional Bond/Sukuk Code Regional Bond/Sukuk Name Acquisition Date Nominal Value Coupon (%) Maturity Date Rating Acquisition Value Fair Value Investment Valuation Difference Economic Sector Remarks Accounting Method Pension Program/ Other Benefits

Nominal Value % ab c d e f g h i j k l m … 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 with Limited Participation Mutual Fund/Mutual Fund whose Shares/Participation Units are Traded on the Indonesia Stock Exchange Fair Value Investment Valuation Difference

DETAILS OF MUTUAL FUNDS
No. Code Product Name Mutual Fund Type *) Investment Manager Acquisition Date Number of Units Remarks Acquisition Value Pension Program/ Other Benefits

Economic Sector
Beginning End Value % ab c d e f g h i j k l m n o p q … Total Acquisition Value Fair Value Investment Valuation Difference Issuer Name

DETAILS OF MTN
No. Code Product Name Acquisition Date Maturity Date Remarks Nominal Value Coupon (%) Rating Pension Program/ Other Benefits

Economic Sector
Beginning End Value % ab c d e f g h i j k l m n o p q … Total

DETAILS OF ASSET-BACKED SECURITIES No. Code Product Name Issuer Name Acquisition Date Nominal Value Coupon (%) Maturity Date Rating Remarks Acquisition Value Fair Value Investment Valuation Difference Pension Program/ Other Benefits

Nominal Value % ab c d e f g h i j k l … Total

DETAILS OF REAL ESTATE INVESTMENT FUNDS IN THE FORM OF COLLECTIVE INVESTMENT CONTRACTS No. Code Product Name Investment Manager Acquisition Date Number of Units Acquisition Value Fair Value Remarks Investment Valuation Difference Pension Program/ Other Benefits

Nominal Value % ab c d e f g h i j k l … Total Remarks

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 Pension Program/ Other Benefits

Nominal Value % ab c d e f g h i j k l … Total Fair Value Investment Valuation Difference

DETAILS OF OPTIONS CONTRACTS AND FUTURES CONTRACTS FOR SECURITIES LISTED ON THE INDONESIA STOCK EXCHANGE No. Issuer Name Buyer Name Acquisition Date Duration Remarks Acquisition Value Pension Program/ Other Benefits

Beginning End Nominal % Value % ab c d e f g h i j k l m n op q r … Total Margin Rating

DETAILS OF REPO
Category
(KSEI/BIS4)
Collateral Type
(GSB/GSI/BOND)
Counterparty No. Acquisition Date Collateral Value Duration Remarks Acquisition Value Sale Value Amortized Cost Investment Valuation Difference Pension Program/ Other Benefits

Position Date % Ownership Total % Ownership Total Date % Ownership Total Value % ab c d e f g h i j k l m n o p q r s … Total *) letter e :
Filled with Domestic CPA/Non-Domestic CPA/Foreign CPA/Non-Foreign CPA Appraisal Value/Fair Value

DETAILS OF DIRECT PARTICIPATION Investment Valuation Difference Remarks No. Company Name Category Participation*) Acquisition Date Initial Placement Acquisition Value As of Report Date Pension Fund Representation Economic Sector Pension Program/ Other Benefits

Object Type
(Land/Building/Land&Building) Value % a b c d e f g h i j k l mn o p q r s … Total Appraisal Value/ Fair Value Investment Valuation Difference Pension Program/ Other Benefits Remarks

DETAILS OF LAND, BUILDINGS, LAND AND BUILDINGS IN INDONESIA No. Address Location (City,Province) Area Date Acquisition Type of Ownership Proof Document Number Ownership Document Name Public/Independent Appraiser Accumulated Depreciation Book Value Year Appraisal Name of Appraisal Firm Acquisition Value

No. Cash/Bank Name No. Account Nominal Pension Program/ Other Benefits Remarks (Purpose of use) ab c d e f … Total

DETAILS OF CASH AND BANKS
Age of Receivables <=3
Months
Age of Receivables >3
Months Total Age of Receivables <=3 Months Age of Receivables >3 Months Total Age of Receivables <=3 Months Age of Receivables >3 Months Total ab c d e f g h i j k l m n … Total

DETAILS OF CONTRIBUTION RECEIVABLES Remarks No. Contribution Receivables Voluntary Participant Employer Name (Founder/Co-Founder) Contribution Receivables Employer Contribution Receivables Participant Contribution Receivables Additional Contribution Pension Program/ Other Benefits

ab c d e f g
…
Total

DETAILS OF INTEREST RECEIVABLES FOR LATE CONTRIBUTIONS Remarks No. Employer Name (Founder/Co-Founder) Interest Receivables on Participant Contributions Interest Receivables on Employer Contributions Interest Receivables on Additional Contributions Pension Program/ Other Benefits

No. Expense Type Amount Pension Program/ Other Benefits Remarks ab c d e … Total

DETAILS OF PREPAID EXPENSES
No. Investment Receivable Type Nominal Pension Program/ Other Benefits Remarks ab c d e … Total

DETAILS OF INVESTMENT RECEIVABLES No.
Investment Income Receivable Type
Nominal Pension Program/
Other Benefits
Remarks ab c d e
…
Total

DETAILS OF INVESTMENT INCOME RECEIVABLES No.
Other Receivable Type
Nominal Pension Program/
Other Benefits
Remarks ab c d e
…
Total

DETAILS OF OTHER RECEIVABLES
No. Land and/or Building Name Certificate Number Address Location Date Acquisition Acquisition Value Accumulated Depreciation Book Value Acquisition Value As of Report Date Remarks ab c d e f g h i j … Total

DETAILS OF LAND AND BUILDINGS
No. Vehicle Plate No. Vehicle Type Date Acquisition Acquisition Value Accumulated Depreciation Book Value Remarks ab c d e f g h … Total

DETAILS OF VEHICLES
No.
Computer Equipment Type
Date Acquisition Acquisition Value Accumulated Depreciation Book Value Remarks ab c d e f g … Total

DETAILS OF COMPUTER EQUIPMENT
No. Office Equipment Type
Date
Acquisition
Acquisition Value Accumulated
Depreciation
Book Value Remarks ab c d e f g
…
Total

DETAILS OF OFFICE EQUIPMENT
No.
Other Operational Asset Type
Date
Acquisition
Acquisition Value Accumulated
Depreciation
Book Value Remarks ab c d e f g
…
Total

DETAILS OF OTHER OPERATIONAL ASSETS No. Other Asset Type Date Acquisition Asset Value Remarks ab c d e … Total Other Asset Details

<= 1 year >1 year Total ab c d e f … Total

DETAILS OF DUE PENSION BENEFIT LIABILITIES Remarks Amount No. Pension Program/ Other Benefits

<= 1 year >1 year Total ab c d e
…
Total
No. Amount

DETAILS OF DUE VOLUNTARY PENSION BENEFIT LIABILITIES Remarks

No. Investment Type Value Pension Program/ Other Benefits Remarks ab c d e … Total

DETAILS OF INVESTMENT LIABILITIES No.
Details of Income
Received in Advance Party Value Pension Program/ Other Benefits Remarks ab c d e f … Total

DETAILS OF ADVANCED INCOME
No.
Details of Expenses
Still to be Paid Party Value Pension Program/ Other Benefits Remarks ab c d e f … Total

DETAILS OF ACCRUED EXPENSES
No. Other Liability Type Party Value Pension Program/ Other Benefits Remarks ab c d e f … Total

DETAILS OF OTHER LIABILITIES
No. Investment Type Investment Valuation Difference Increase/Decrease Pension Program/ Other Benefits Remarks ab c d e f ... Total Investment Increase/Decrease Details

% Amount % Amount ab c d e f g h i j k l m n o p r s ... Total Voluntary Participant Contributions Additional Contributions Additional Contributions Additional Contributions Voluntary Participant Contributions Normal Participant Contributions Normal Participant Contributions Details of Due Contributions Remarks Pension Program/ Other Benefits No. Founder Name/Co-Founder Name PhDP Under/Overpaid Contribution Receipts Due Contributions Normal Participant Contributions Normal Participant Contributions Employer

No.
Other Investment Income
Type
Amount Pension Program/
Other Benefits
Remarks ab c d e
...
Total
Details of Income Outside Investment

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

No. Expense Type Amount Pension Program/ Other Benefits Remarks ab c d e ... Total Details of Investment Expenses

No. Expense Type Amount Pension Program/ Other Benefits Remarks ab c d e ... Total Details of Operational Expenses

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

No.
Income Tax Type
Amount Pension Program/
Other Benefits
Remarks ab c d e
…
Total
Details of Income Tax

No.
Pension Fund that receives Transfer Amount Pension Program/ Other Benefits Details of Other Benefits *) Remarks ab c d e f ... Total *) letter e:
Details of Transfers to Other Pension Funds Filled with Education Fund/Housing Fund/Religious Worship Fund/Disability Benefits/Death Benefits/Health Benefits/Severance Fund/Additional Benefits

FORMAT I B
To
Directorate of Statistics and Information IKNB Financial Services Authority MONTHLY REPORT / ANNUAL FINANCIAL REPORTELECTRONIC DATA DEFINITE 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 Manager Name Manager Position SID Number Audit Data Auditor License Decree Audit Type Auditor Code Auditor Name Opinion Auditing Body Audit Date Report Preparers Officer Name Division Telephone Fax Email Manager Responsible Person Responsible Person Name Position Telephone Fax E-mail Pension Fund Address

Details Breakdown
Code
Percentage
Investment Pension Program Other Benefits Combined ASSETS INVESTMENT Bank Savings 1101 Bank On-call Deposits 1102 Bank Time Deposits 1103 Bank Certificate of Deposits 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 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 INVESTMENT CURRENT ASSETS OUTSIDE INVESTMENT Cash and Banks 1201 Contribution Receivables 1202

Normal Employer Contributions
Normal Participant Contributions
Voluntary Participant Contributions
Interest Receivables for Late Contributions 1203 Prepaid Expenses 1204 Investment Receivables 1205 Investment Income Receivables 1206 Other Receivables 1207 TOTAL CURRENT ASSETS OUTSIDE INVESTMENT 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 Pension Benefit Liabilities Due Pension Benefit and Other Benefits Liabilities 1501 Voluntary Benefit Liabilities 1502 Investment Liabilities 1503 Advanced Income 1504 Accrued Expenses 1505 Other Liabilities 1506 Total Liabilities outside Pension Benefit Liabilities TOTAL LIABILITIES NET ASSETS DEFINITE CONTRIBUTION PENSION PROGRAM NET ASSET REPORT Per DD-MM-YYYY

Pension Program Other Benefits Combined INCREASES 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

Normal Employer Contributions
Normal Participant Contributions
Voluntary Participant Contributions
Income Outside Investment 403
Transfers of Funds from Other Pension Funds 404 Total Increases DECREASES Investment Expenses 405 Operational Expenses 406 Expenses Outside Investment and Operations 407 Pension Benefits and Other Benefits Income Tax 408 Transfers of Funds to Other Pension Funds 409 Total Decreases INCREASE (DECREASE) IN NET ASSETS NET ASSETS AT THE BEGINNING OF THE PERIOD NET ASSETS AT THE END OF THE PERIOD Details Code DEFINITE CONTRIBUTION PENSION PROGRAM NET ASSET CHANGE REPORT Per DD-MM-YYYY Details Accumulated as of DD-MM-YYYY

Pension Program Other Benefits Combined ASSETS INVESTMENT (Historical Value) Bank Savings Bank On-call Deposits Bank Time Deposits Bank Certificate of Deposits 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 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 Building Depreciation TOTAL INVESTMENT INVESTMENT VALUATION DIFFERENCE CURRENT ASSETS OUTSIDE INVESTMENT Cash and Banks Contribution Receivables

Normal Employer Contributions
Normal Participant Contributions
Voluntary Participant Contributions
Interest Receivables for Late Contributions Prepaid Expenses Investment Receivables Investment Income Receivables Other Receivables TOTAL CURRENT ASSETS OUTSIDE INVESTMENT 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 OUTSIDE PENSION BENEFIT LIABILITIES Due Pension Benefit and Other Benefits Liabilities Voluntary Benefit Liabilities Investment Liabilities Advanced Income Accrued Expenses Other Liabilities TOTAL LIABILITIES OUTSIDE PENSION BENEFIT LIABILITIES TOTAL LIABILITIES Details DEFINITE CONTRIBUTION PENSION PROGRAM BALANCE SHEET Per DD-MM-YYYY Accumulated as of DD-MM-YYYY

PPMP_LPHU
Pension Program Other Benefits Combined 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 Expenses Custodian Expenses Other Investment Expenses Total Investment Expenses INVESTMENT OPERATING RESULTS OPERATIONAL EXPENSES Salaries/Honorary Fees for Employees, Managers, and Supervisory Board Office Expenses Maintenance Expenses Depreciation Expenses Third-party Service Expenses Other Operational Expenses Total Operational Expenses OTHER INCOME AND EXPENSES Interest Receivables for Late Contributions Profit (Loss) on Sale of Operational Assets Profit (Loss) on Sale of Other Assets Other Income Outside Investment Expenses Outside Investment and Operations Total Other Income and Expenses INCOME BEFORE TAX INCOME TAX INCOME AFTER TAX DEFINITE CONTRIBUTION PENSION PROGRAM INCOME STATEMENT Per DD-MM-YYYY Details Accumulated as of DD-MM-YYYY

Pension Program Other Benefits Combined CASH FLOWS FROM INVESTMENT ACTIVITIES Receipts of Interest/Profit Sharing Receipts of Dividends Receipts 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 Investment Expenses Outside Investment and Operations Income Tax Net Cash Flows from Operational Activities CASH FLOWS FROM FINANCING ACTIVITIES Receipts of Normal Employer Contributions Receipts of Normal Participant Contributions Receipts of Interest Receivables for Late Contributions Receipts of Transfers of Funds from Other Pension Funds Payments of Transfers of Funds to Other Pension Funds Payment of Pension Benefits & Other Benefits Net Cash Flows from Financing Activities INCREASE (DECREASE) IN NET CASH CASH AT THE BEGINNING OF THE PERIOD CASH AT THE END OF THE PERIOD Details DEFINITE CONTRIBUTION PENSION PROGRAM CASH FLOW STATEMENT Per DD-MM-YYYY Accumulated as of DD-MM-YYYY

(3) Total DPPK Participants (1) + (2) Other benefits

Widows/Widowers
Children
Deferred Pension
b. Co-Founders
Pensioners
Widows/Widowers
(1) Active Participants a. Founders b. Co-Founders (2) Inactive Participants a. Founders
Pensioners

Details Pension Fund Amount
PENSION FUND PARTICIPATION
Per DD-MM-YYYY

Children
Deferred Pension

Bank Savings
Bank On-call Deposits
Bank Time Deposits
Bank Certificate of Deposits
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 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 INVESTMENT Dec DEFINITE CONTRIBUTION PENSION PROGRAM Sep Oct INVESTMENT RECAP Per DD-MM-YYYY May Jun Jul Aug Details Jan Feb Mar Apr Nov

Bank Savings Time Deposits Certificate of Deposits SBI GSB Investment Assets Total Participants Total Funds Life Cycle Fund Assets Per DD-MM-YYYY

Interest/Profit Sharing Dividends Rent Profit/Loss Disposal Others Bank Savings Bank On-call Deposits Bank Time Deposits Bank Certificate of Deposits Securities issued by Bank Indonesia Government Securities Shares listed on the Indonesia Stock Exchange Corporate bonds listed on the Indonesia Stock Exchange Sukuk 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 DEFINITE CONTRIBUTION PENSION PROGRAM INVESTMENT INCOME REPORT Per DD-MM-YYYY Investment Type Realized Investment Income Average ROI Investment Net Investment Income Investment Expenses Unrealized Investment Income

Interest/Profit Sharing Dividends Rent Profit/Loss Disposal Others Bank Savings Bank On-call Deposits Bank Time Deposits Bank Certificate of Deposits Securities issued by Bank Indonesia Government Securities Shares listed on the Indonesia Stock Exchange Corporate bonds listed on the Indonesia Stock Exchange Sukuk 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 DEFINITE CONTRIBUTION PENSION PROGRAM OTHER BENEFITS INVESTMENT INCOME REPORT Per DD-MM-YYYY Investment Type Realized Investment Income Unrealized Investment Income Investment Expenses Net Investment Income 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 Bank On-call Deposits Bank Time Deposits Bank Certificate of Deposits 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 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 Investment B. Current Assets Outside Investment Cash & Banks Contribution Receivables Normal Employer Contributions Normal Participant Contributions Voluntary Participant Contributions Interest Receivables for Late Contributions Prepaid Expenses Investment Receivables Investment Income Receivables Other Receivables Total Current Assets Outside Investment
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 Outside Pension Benefit Liabilities Due Pension Benefit and Other Benefits Liabilities Voluntary Benefit Liabilities Investment Liabilities Advanced Income Accrued Expenses Other Liabilities Total Liabilities Outside Pension Benefit Liabilities H. Total Liabilities (F+G)
I. Difference between Total Assets and Total Liabilities (E-H)
J. Percentage (%) Fund Adequacy Ratio DEFINITE CONTRIBUTION PENSION PROGRAM Total ASSET AND LIABILITY RECAPITULATION Per DD-MM-YYYY (in rupiah) Maturity >= 10 Years Details Maturity < 1 year 1 year <= Maturity < 5 years 5 years <= Maturity < 10 years

Type Amount Percentage Against Total Investment ab c d e f g … Details of Investment in One Party No Name of Counterparty Investment Limit in Directive Investment Limit of Investment According to Regulations As of DD-MM-YYYY

Name Type
Investment
Balance Name Type
Investment
Security Series Ownership Type Rating Balance Name Type Investment Investment Manager Fair Value % Government Bonds in Mutual Funds Balance Name Type Investment Investment Manager Issuer of Funds/Project Balance Name Type Investment Security Series Ownership Type Rating Balance Name Type Investment Balance ….. Total DETAILS OF COMPLIANCE WITH REGULATIONS REGARDING GOVERNMENT BOND INVESTMENTS Government Bonds Bonds / Sukuk Infrastructure Mutual Funds Underlying Government Bonds Limited Participation Mutual Funds Secured Assets Other Investments for Financing Infrastructure Projects Government No Investment Income Ratio (ROI) A. Investment income after deducting operational investment expenses B. Average investments
C. Ratio (a:b)
Investment Income to Assets Ratio (ROA) A. Investment income + other income - investment and non-investment expenses B. Total Available Assets
C. Ratio (a:b)
Operational Expense Ratio (BOPO)
A. Operational Expenses
B. Total Available Assets
C. Ratio (a:b)
FINANCIAL RATIOS
Description Total Other Benefits Pension Program As of DD-MM-YYYY (in millions of rupiah) Bill Number Nominal Maturity Date Acquisition Value Fair Value Maturity Date Total Description PENSION FUNDS PERIODIC PENSION BENEFIT INVESTMENT REPORT Bank Name/Security Series Government Bonds Deposits Government Bonds Total Number of Participants Monthly Benefits Lump Sum Benefits Initial Reserve (20%)

No. Name of
Investment Manager
Contract Number Contract Date Agreement Term Type of Investment Amount of Funds Managed (Rp) Rate of Net Investment Return (Rp) Amount of 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 Disclosure of Investment Managers Pension Fund Use of Investment Managers As of DD-MM-YYYY Total etc.

ab c d e f g
…
Total
SAVINGS DETAILS
No Bank Name Acquisition Date Nominal Value Interest Rate/Nisbah Description Pension Program/ Other Benefits

ab c d e f g h
…
Total
ON-CALL DEPOSIT DETAILS
No Bank Name Acquisition Date Nominal Value Tenor Interest Rate/Nisbah Description Pension Program/ Other Benefits

ab c d e f g h
…
Total
TERM DEPOSIT DETAILS
No Bank Name Acquisition Date Nominal Value Tenor Interest Rate/Nisbah Description Pension Program/ Other Benefits

ab c d e f g h i j
…
Total
CERTIFICATE OF DEPOSIT DETAILS
No Bank Name Acquisition Date Nominal Value Tenor Interest Rate/Nisbah Description Acquisition Value Cash Value Pension Program/ Other Benefits

Value % ab c d e f g h i j k l
…
Total
Description
INDONESIAN SECURITIES DETAILS
No
Securities Code Acquisition Date Nominal Value Maturity Date Acquisition Value Fair Value Valuation Difference Investment Pension Program/ Other Benefits Coupon (%)

Value % ab c d e f g h i j k l m
…
Total
Description
GOVERNMENT SECURITIES DETAILS
No Securities Code Acquisition Date Nominal Value Maturity Date Acquisition Value Fair Value Valuation Difference Investment Coupon (%) Pension Program/ Other Benefits Accounting Method

Value % ab c d e f g h i j k l
…
Total
Description
SHARES DETAILS
No Share Code Issuer / Issuing Company Acquisition Date Number of Shares Acquisition Value Market Value Valuation Difference Investment Economic Sector Pension Program/ Other Benefits

Beginning End Value % ab c d e f g h i j k l m n o p qr … Total Coupon (%) Pension Program/ Other Benefits BONDS DETAILS No Issuer Name Bond Code Bond Name Acquisition Date Nominal Value Maturity Date Rating Economic Sector Accounting Method Acquisition Value Fair Value Valuation Difference Investment Description

Beginning End Value % ab c d e f g h i j k l m n o p q r … Total SUKEK DETAILS No Issuer Name Sukuk Code Sukuk Name Acquisition Date Nominal Value Maturity Date Rating Economic Sector Accounting Method Coupon (%) Pension Program/ Other Benefits Acquisition Value Fair Value Valuation Difference Investment Description

Beginning End Value % ab c d e f g h i j k l m n o p q r … Total Coupon (%) Pension Program/ Other Benefits Description REGIONAL BONDS/SUKUK DETAILS No Issuer Name Regional Bond/Sukuk Code Regional Bond/Sukuk Name Acquisition Date Nominal Value Maturity Date Rating Acquisition Value Fair Value Valuation Difference Investment Economic Sector Accounting Method

Value % ab c d e f g h i j k l m
…
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 Valuation Difference Investment Description MUTUAL FUNDS DETAILS No Code Product Name Type of Mutual Fund *) Investment Manager Acquisition Date Number of Units Acquisition Value Fair Value Pension Program/ Other Benefits

Beginning End Value % ab c d e f g h i j k l m n o p q … Total Description MTN DETAILS No Code Product Name Issuer Name Acquisition Date Nominal Value Rating Economic Sector Coupon (%) Maturity Date Pension Program/ Other Benefits Acquisition Value Fair Value Valuation Difference Investment

Nominal Value Economic Sector
Beginning End Value % ab c d e f g h i j k l m n o p q … Total SECURED ASSETS DETAILS No Code Product Name Issuer Name Acquisition Date Maturity Date Rating Coupon (%) Pension Program/ Other Benefits Acquisition Value Fair Value Valuation Difference Investment Description

Value % ab c d e f g h i j k l
…
Total
Description
COLLECTIVE INVESTMENT CONTRACT REAL ESTATE INVESTMENT FUNDS DETAILS No Code Product Name Investment Manager Acquisition Date Number of Units Acquisition Value Fair Value Valuation Difference Investment Pension Program/ Other Benefits

Value % ab c d e f g h i j k l
…
Total
Description
COLLECTIVE INVESTMENT CONTRACT INFRASTRUCTURE INVESTMENT FUNDS DETAILS No Code Product Name Investment Manager Acquisition Date Number of Units Acquisition Value Net Asset Value Valuation Difference Investment Pension Program/ Other Benefits

Value % ab c d e f g h i j k
…
Total
Description
OPTIONS CONTRACTS AND FINANCIAL FUTURES CONTRACTS RECORDED ON THE INDONESIAN STOCK EXCHANGE DETAILS No Issuer Name Buyer Name Acquisition Date Tenor Acquisition Value Fair Value Valuation Difference Investment Description Pension Program/ Other Benefits

Beginning End Nominal % Value % ab c d e f g h i j k l m n op q r … Total Pension Program/ Other Benefits Margin Description REPO DETAILS No Counterparty Type of Collateral (Government Bonds/Bills/Bonds) Acquisition Date Collateral Value Rating Tenor Category (KSEI/BIS4) Acquisition Value Amortized Cost Sale Value Valuation Difference Investment

Economic Sector
Job Title Date % Ownership Total % Ownership Total Date % Ownership Total Value % ab c d e f g h i j k l m n o p q r s … Total ) letter e :
Filled with Domestic Employer/Non-Domestic Employer/Foreign Employer/Non-Foreign Employer DIRECT PARTICIPATION DETAILS No Company Name Category of Participation) Acquisition Date Initial Placement Acquisition Value As of Report Date Appraisal/Fair Value Valuation Difference Investment Description Pension Fund Representative Pension Program/ Other Benefits

Object Type
(Land/Building/Land&Building) Value % a b cde f gh i j k lm n opq r s … Total Name of Public/Independent Appraiser Appraisal Firm Name Appraisal Value/ Fair Value Valuation Difference Investment Description Pension Program/ Other Benefits LAND, BUILDINGS, LAND AND BUILDINGS IN INDONESIA DETAILS No Location Address (City, Province) Area Acquisition Date Acquisition Value Type of Ownership Proof Document Number of Ownership Accumulated Depreciation Book Value Year Appraisal

No Cash/Bank Name Account Number Nominal Pension Program/ Other Benefits Description (Purpose of use) ab c d e f … Total CASH AND BANK DETAILS Receivable Age <=3 Months Receivable Age >3 Months Total Receivable Age <=3 Months Receivable Age >3 Months Total ab c d e f g h l m n … Total CONTRIBUTION RECEIVABLES DETAILS No Name of Contributor (Founder/Co-Founder) Employer Contribution Receivable Participant Contribution Receivable Voluntary Participant Contribution Receivable Description Pension Program/ Other Benefits

ab c d e f
…
Total
INTEREST RECEIVABLES FOR LATE CONTRIBUTIONS DETAILS No Name of Contributor Participant Contribution Interest Receivable Employer Contribution Interest Receivable Pension Program/ Other Benefits Description

No Type of Expense Amount Pension Program/ Other Benefits Description ab c d e … Total PREPAID EXPENSES DETAILS

No Type of Investment Receivable Nominal Pension Program/ Other Benefits Description ab c d e … Total INVESTMENT RECEIVABLES DETAILS

No Type of Investment Return Receivable Nominal Pension Program/ Other Benefits Description ab c d e … Total INVESTMENT RETURN RECEIVABLES DETAILS

No Type of Other Receivables Nominal Pension Program/ Other Benefits Description ab c d e … Total OTHER RECEIVABLES DETAILS

No Name of Land and/or
Building
Certificate Number Location Address Acquisition Date Acquisition Value Accumulated Depreciation Book Value Acquisition Value On Report Date Description ab c d e f g h i j … Total LAND AND BUILDINGS DETAILS

No Vehicle Plate Number Type of Vehicle Acquisition Date Acquisition Value Accumulated Depreciation Book Value Description ab c d e f g h … Total VEHICLES DETAILS

No Type of Computer
Equipment
Acquisition Date Acquisition Value Accumulated Depreciation Book Value Description ab c d e f g … Total COMPUTER EQUIPMENT DETAILS

No Type of Office
Equipment
Acquisition Date Acquisition Value Accumulated Depreciation Book Value Description ab c d e f g … Total OFFICE EQUIPMENT DETAILS

No Type of Other Operational
Assets
Acquisition Date Acquisition Value Accumulated Depreciation Book Value Description ab c d e f g … Total OTHER OPERATIONAL ASSETS DETAILS

No Type of Other Assets Acquisition Date Asset Value Description ab c d e … Total Other Assets Details <= 1 year >1 year Total ab c d e f … Total MATURITY DETAILS OF PENSION BENEFIT LIABILITIES No Amount Description Pension Program/ Other Benefits

<= 1 year >1 year Total ab c d e
…
Total
MATURITY DETAILS OF VOLUNTARY PENSION BENEFIT LIABILITIES No Amount Description

No Type of Investment Value Pension Program/ Other Benefits Description ab c d e … Total INVESTMENT LIABILITIES DETAILS

No
Details of Income
Received in Advance Party Value Pension Program/ Other Benefits Description ab c d e f … Total ADVANCED INCOME DETAILS

No
Details of Expenses
Still to be Paid Party Value Pension Program/ Other Benefits Description ab c d e f … Total EXPENSES PAYABLE DETAILS

No Type of Other Liabilities Party Value Pension Program/ Other Benefits Description ab c d e f … Total OTHER LIABILITIES DETAILS

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

% Amount % Amount ab c d e f g h i j k l m n o ...
Total
Details of Due Contributions
No.
Name of Founder/
Co-Founder PhDP
Due Contributions Underpayment/Overpayment Voluntary Participant Contributions Voluntary Participant Contributions Pension Program/ Other Benefits Description Normal Participant Contributions Normal Employer Contributions Normal Participant Contributions Normal Employer Contributions Contribution Receipts Normal Participant Contributions Normal Employer Contributions

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

No.
Name of Pension Fund transferring Amount Pension Program/ Other Benefits Details of Other Benefits *) Description ab c d e f ... Total *) letter e:
Details of Transfer from Other Pension Funds Filled with Education Fund/Housing Fund/Religious Worship Fund/Disability Assistance/Death Assistance/Health Assistance/Severance Pay Fund/Additional Benefit Fund

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

No. Type of Expense Amount Pension Program/ Other Benefits Description ab c d e ... Total Operational Expenses Details

No. Type of Expense Amount Pension Program/ Other Benefits Description ab c d e ... Total Expenses Outside Investments and Operations

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

No.
Pension Fund receiving
Transfer Amount Pension Program/ Other Benefits Details of Other Benefits *) Description ab c d e f ... Total *) letter e:
Details of Transfer to Other Pension Funds Filled with Education Fund/Housing Fund/Religious Worship Fund/Disability Assistance/Death Assistance/Health Assistance/Severance Pay Fund/Additional Benefit Fund

FORMAT I C
FORM 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) :
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. Fax (area code - fax) :
h. Email :
i. Website :
B. Founder
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. Fax (area code - fax) :
h. Email :
i. Website :
C. Organization

Management
a. Is there any change in management or extension of term of office of managers during the period of activity? If Yes, has this been reported to OJK? b. Have the Managers obtained basic knowledge certificates in the field of Pension Funds
c. Have the Managers who have
obtained basic knowledge certificates in the field of Pension Funds met the minimum points for continuing education? d. Is there any change in the Supervisory Board or extension of term of office of the Supervisory Board during the period of activity? If Yes, has this been reported to OJK?
Number of Pension Fund Employees
Based on Education Level
Elementary School (SD) :
Junior High School (SMP) :
Senior High School (SMU) :
Diploma :
Bachelor's Degree (S1) :
Master's Degree (S2) :
Doctorate (S3) :
Total :
Third-Party Service Users:
a. Does the Pension Fund use third-party services to manage membership administration? If Yes, Fill in the name of Membership Administration Manager:
5 etc b. Does the Pension Fund use third-party services to entrust ownership documents of assets If YES, fill in the name of the custodian used 5 etc
c. Does the Pension Fund
use Investment Manager services?
If YES, fill in the list of names of Investment Managers used (sorted by proportion of managed assets) 5 etc d. Does the Pension Fund use Appraiser services? If YES, fill in the list of information of Appraisers used:

5 etc
4. Contributions
a. Does the Employer pay contributions in the correct amount? b. Does the Employer pay contributions on time?
5. Investments
a. Are investment activities during the reporting period in accordance with regulatory provisions? b. Has information regarding investments been communicated to participants?
6. Governance
a. Does the Pension Fund have
Pension Fund Governance Guidelines? b. Has the Pension Fund implemented Pension Fund Governance? D. Pension Fund Membership

Number of Active Pension Fund Employee Participants at the end of the activity period:
Founder (persons) :
Co-Founder(persons) :
Total (persons) :
Number of all participants entitled to
t deferred pension at the end of the activity period :
Age Structure of Active Participants and
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 t deferred pension up to 20 :
20 up to 30 :
30 up to 40 :
40 up to 50 :
above 50 :
Estimated number of participants entering normal retirement age in one subsequent activity period :
Number of all employers who include their employees in
DPLK at the end of the activity period

E. Pensioners and Persons Entitled Description Amount < Rp. 750,000.00 Rp. 750,000.00 - Rp. < 2,000,000.00 Rp. 2,000,000.00

Rp.
5,000,000.00

Rp.
5,000,000.00

Number of Beneficiaries

a. Number of Beneficiaries
Monthly Pension at the end of the period (activity (including those who choose maximum first payment 20%) -
i. Pensioners
ii. Widows/Widowers
iii. Children
b. Number of Beneficiaries
Pension who receive payments lump sum during the period activity with reasons:
i. Monthly pension
benefit below ministerial regulation limit
ii. Reasons other than item b (i)
c. Number of Beneficiaries
Pension undergoing annuity purchase during the period

Distribution of number
pension beneficiaries based on category of large pension benefits received monthly at the end of the period activity
i. Pensioners (persons)
ii. Widows/Widowers
iii. Children
Manager Statement
We, the Managers of the Pension Fund, declare that all data and information we provide in this technical report are true data and correspond to the actual conditions of the Pension Fund. If it is later found that there is data/information that does not correspond to the actual conditions, then we are willing to be accountable according to regulatory provisions. Place, Date (date/month/year) (signature) Full Name Position

II. Performance Evaluation Report by the Supervisory Board
(report substance is filled in by the supervisory board considering the Reasonableness Reasons of the Management in explaining the inconsistency of Pension Fund Investment Performance with Investment Directives and Annual Investment Plan)

III. Pension Fund Risk Assessment Results Report
Pension Fund Name :
Type : (1) DPPK PPMP (2) DPPK PPIP (3) DPLK Assessment Date :
Report Date :
A. General Information
Founders and Co-Founders :
Name Description Number
Participants
Managers :
Name Position Term of Office
Supervisory Board :
Name Position/Representative Term of Office Financial Information As of Assessment Date Description Value (Rupiah) Ratio per Net Assets Net Assets Investments Normal Contribution Receivables Additional Contribution Receivables Other Receivables Other Assets Business Results* Funding Ratio (PPMP) Solvency Ratio (PPMP) Return on Investment (ROI)* Number of Participants *For the last one-year period since the assessment date B. Risk Assessment Overview Risk Type Risk Value Net Risk Weight

Management
Governance
Strategy
3.1 Inherent Risk
3.2 Management and Control
Operational
4.1 Inherent Risk

4.2 Management and Control
5. Assets and Liabilities
5.1 Inherent Risk
5.2 Management and Control
Total Net Risk Value

Funding Capability
Additional Funding
Total Fund Support Risk Value
Total Net Risk Value
Total Capitalization
Risk Value
Risk Level
C. Risk Description
General Description
Description per Risk Type
Management Risk Risk Value:.... Risk Level: ...
Description:
Governance Risk Risk Value:.... Risk Level: ...
Description:
Strategy Risk Risk Value:.... Risk Level: ...
Inherent Risk Value:
Description:
Management and Control Value:
Description:
Operational Risk Risk Value:.... Risk Level: ...
Inherent Risk Value:
Description:
Management and Control Value:

Description:
Assets and Liabilities Risk Risk Value:.... Risk Level: ... Inherent Risk Value:
Description:
Management and Control Value:
Description:
Fund Support Risk Risk Value:.... Risk Level: ...
Funding Capability Value:
Description:
Additional Funding Value:
Description:
Acknowledged,
Name:
Position:
Prepared by:
Name:
Position:

IV. Follow-up Plan Based on Pension Fund Risk Assessment

Name :
Type :
(1) DPPK PPMP
(2) DPPK PPIP
(3) DPLK
Risk Assessment Date :
Report Date :
Risk Level: 6. Risk Value :
Risk Type 8. Cause of Risk 9. Plan
Follow-up Action
Target Time 11. PIC
Prepared by
Name
:
Signature
Position
:
Acknowledged
Name
:
Signature
Position
:
Filling Guidelines:
Fill in the Pension Fund name.
Fill in the type of Pension Fund by choosing one from the existing list.
Fill in the risk assessment date that serves as the basis for the follow-up plan.
Fill in the date of the signed risk assessment report.
Fill in the Pension Fund risk level according to the results of the risk assessment as referred to in point 3.
Fill in the Pension Fund risk value according to the results of the risk assessment as referred to
in point 3.
Fill in the risk type as referred to in POJK number 10/POJK.05/2014 concerning
Risk Assessment of Non-Bank Financial Service Institutions.
Fill in the cause of risk.
Fill in the plan for various follow-up steps to be taken to reduce
the risk level for each area of risk type.
Fill in the target time for implementation of follow-up actions to be taken for each step
of follow-up action, which can be the completion date of follow-up or the start and end dates of follow-up if the target time for starting follow-up is not immediately after the follow-up plan is drawn up.
Fill in the unit responsible for implementing follow-up actions.
Fill in the name of the official preparing the follow-up plan for the Pension Fund risk assessment.
Fill in the signature of the official preparing the follow-up plan for the Pension Fund risk assessment.
Fill in the job title of the official preparing the follow-up plan for the Pension Fund risk assessment.
Fill in the name of the Pension Fund manager handling Pension Fund risk management.
Fill in the signature of the Pension Fund manager handling Pension Fund risk management.
Fill in the job title of the Pension Fund manager handling Pension Fund risk management.

V. Self-Assessment Report on the Implementation of Risk
Management
SELF-ASSESSMENT REPORT
ON THE IMPLEMENTATION OF RISK MANAGEMENT PENSION FUND YEAR … PENSION FUND XYZ (Address of Pension Fund)

SELF-ASSESSMENT REPORT
ON THE IMPLEMENTATION OF PENSION FUND RISK MANAGEMENT Pension Fund Name :
Pension Fund Type : (1) DPPK PPMP (2) DPPK PPIP (3) DPLK Assessment Date :
Position Date
Report Date :
A. GENERAL INFORMATION
Founders and Co-Founders:
No. Name Description Number of Participants 1.
2. etc.
Managers:
No. Name Position Term of Office
1.
2.
3. etc.
Supervisory Board:
No. Name Position Term of Office
1.
2.
3. etc.

B. PENSION FUND FINANCIAL INFORMATION Description Value (Rupiah) Ratio per Net Assets Net Assets Investments Normal Contribution Receivables Additional Contribution Receivables Other Receivables Other Assets Business Results* Funding Ratio (PPMP) Solvency Ratio (PPMP) Return on Investment (ROI)* Number of Participants

For the last one-year period since the assessment date
C. SUMMARY OF RISK MANAGEMENT IMPLEMENTATION IN GENERAL

Active Supervision by Directors and Commissioners
…………… (Filled with description of the role of Directors and Commissioners in Risk Management and Risk Management organizational structure)
Adequacy of Policies, Procedures, and Risk Limit Setting
…………… (Filled with description of risk appetite, risk tolerance, and setting of Risk Limits)
Adequacy of Risk Identification, Measurement, Monitoring, and
Control Processes
…………… (Filled with description of identification, measurement, monitoring, and control processes of Risk)
Risk Management Information System
…………… (Filled with description of how the pension fund information system supports the implementation of Risk Management)
Comprehensive Internal Control System
…………… (Filled with description of how internal control including compliance function is carried out by the pension fund)

D. APPLICATION OF RISK MANAGEMENT FOR EACH TYPE OF RISK

Strategic Risk
Application Coverage
Risk Management Description
Active Supervision
Board of Directors and Board of Commissioners …………… (Filled with a description of the active supervision by the Board of Directors and Board of Commissioners over Strategic Risk) Adequacy of Policies, Procedures, and Risk Limit Setting …………… (Filled with a description of risk appetite, risk tolerance, and the setting of limits for Strategic Risk) Adequacy of the Process for Risk Identification, Measurement, Monitoring, and Control …………… (Filled with a description of the process for identification, measurement, monitoring, and control of Strategic Risk) Information System for Strategic Risk Management …………… (Filled with a description of how the pension fund's information system supports the application of Risk Management for Strategic Risk) Comprehensive Internal Control System …………… (Filled with a description of how internal control, including the compliance function, is conducted by the pension fund for Strategic Risk)
Operational Risk
Application Coverage
Risk Management Description
Active Supervision
Board of Directors and Board of Commissioners …………… (Filled with a description of the active supervision by the Board of Directors and Board of Commissioners over Operational Risk) Adequacy of Policies, Procedures, and Risk Limit Setting …………… (Filled with a description of risk appetite, risk tolerance, and the setting of limits for Operational Risk) Adequacy of the Process for Risk Identification, Measurement, Monitoring, and Control …………… (Filled with a description of the process for identification, measurement, monitoring, and control of Operational Risk) Information System for Operational Risk Management …………… (Filled with a description of how the pension fund's information system supports the application of Risk Management for Operational Risk) Comprehensive Internal Control System …………… (Filled with a description of how internal control, including the compliance function, is conducted by the pension fund for Operational Risk)
Asset and Liability Risk
Application Coverage
Risk Management Description
Active Supervision
Board of Directors and Board of Commissioners …………… (Filled with a description of the active supervision by the Board of Directors and Board of Commissioners over Asset and Liability Risk) Adequacy of Policies, Procedures, and Risk Limit Setting …………… (Filled with a description of risk appetite, risk tolerance, and the setting of limits for Asset and Liability Risk) Adequacy of the Process for Risk Identification, Measurement, Monitoring, and Control …………… (Filled with a description of the process for identification, measurement, monitoring, and control of Asset and Liability Risk) Information System for Risk Management …………… (Filled with a description of how the pension fund's information system supports the application of Risk Management for Asset and Liability Risk) Comprehensive Internal Control System …………… (Filled with a description of how internal control, including the compliance function, is conducted by the pension fund for Asset and Liability Risk)
Management Risk
Application Coverage
Risk Management Description
Active Supervision
Board of Directors and Board of Commissioners …………… (Filled with a description of the active supervision by the Board of Directors and Board of Commissioners over Management Risk) Adequacy of Policies, Procedures, and Risk Limit Setting …………… (Filled with a description of risk appetite, risk tolerance, and the setting of limits for Management Risk) Adequacy of the Process for Risk Identification, Measurement, Monitoring, and Control …………… (Filled with a description of the process for identification, measurement, monitoring, and control of Management Risk) Information System for Risk Management …………… (Filled with a description of how the pension fund's information system supports the application of Risk Management for Management Risk) Comprehensive Internal Control System …………… (Filled with a description of how internal control, including the compliance function, is conducted by the pension fund for Management Risk)
Governance Risk
Application Coverage
Risk Management Description
Active Supervision
Board of Directors and Board of Commissioners …………… (Filled with a description of the active supervision by the Board of Directors and Board of Commissioners over Governance Risk) Adequacy of Policies, Procedures, and Risk Limit Setting …………… (Filled with a description of risk appetite, risk tolerance, and the setting of limits for Governance Risk) Adequacy of the Process for Risk Identification, Measurement, Monitoring, and Control …………… (Filled with a description of the process for identification, measurement, monitoring, and control of Governance Risk) Information System for Risk Management …………… (Filled with a description of how the pension fund's information system supports the application of Risk Management for Governance Risk) Comprehensive Internal Control System …………… (Filled with a description of how internal control, including the compliance function, is conducted by the pension fund for Governance Risk)
Funding Support Risk
Application Coverage
Risk Management Description
Active Supervision
Board of Directors and Board of Commissioners …………… (Filled with a description of the active supervision by the Board of Directors and Board of Commissioners over Funding Support Risk) Adequacy of Policies, Procedures, and Risk Limit Setting …………… (Filled with a description of risk appetite, risk tolerance, and the setting of limits for Funding Support Risk) Adequacy of the Process for Risk Identification, Measurement, Monitoring, and Control …………… (Filled with a description of the process for identification, measurement, monitoring, and control of Funding Support Risk) Information System for Risk Management …………… (Filled with a description of how the pension fund's information system supports the application of Risk Management for Funding Support Risk) Comprehensive Internal Control System …………… (Filled with a description of how internal control, including the compliance function, is conducted by the pension fund for Funding Support Risk)

Prepared by, Acknowledged,
(Signature) (Signature)
(Name) (Name)
(Position) (Position)

VI. Report on the Application of Pension Fund Governance

Transparency of Good Governance Application for Pension Funds

a. DPPK Management Board

Number, names, positions, criteria, appointment dates, terms of office, citizenship, and domicile of DPPK Management Board members
No Name Position Criteria Appointment Date Term of Office Citizenship Domicile Latest Formal Education and Professional Degree Competency and Propriety Test 1. 2. Etc.
Concurrent positions of DPPK Management Board members
No. Name Position at Pension Fund Position at Other Pension Fund Position at Other Companies and/or Institutions 1. 1. 2. Etc. 2. 1. 2. Etc. Etc.
Frequency of DPPK Management Board meetings held within 1 (one) month.
No Name Position Number of Management Board Meetings (... meetings) % Attendance Number of Physical Attendees Teleconference/Video/Conference/Other Electronic Media Facilities 1. 2. Etc.
Family relationships between DPPK Management Board members and members of the DPPK Supervisory Board and/or Sharia Supervisory Board at the Pension Fund where the DPPK Management Board member in question serves.
No. Name Family Relationship with DPPK Supervisory Board Sharia Supervisory Board Yes No Ket* Yes No Ket* 1. 2. Etc.

Note:
*) Form of family relationship: spouse/child/parent/sibling/in-law, etc.

b. Supervisory Board

Number, names, positions, criteria, appointment dates, terms of office, citizenship, and domicile of Supervisory Board members
No Name Position Criteria Appointment Date Term of Office Citizenship Domicile Latest Formal Education and Professional Degree Competency and Propriety Test 1. 2. Etc.
Concurrent positions of Supervisory Board members
No. Name Position at Pension Fund Position at Other Pension Fund Position at Other Companies and/or Institutions 1. 1. 2. Etc. 2. 1. 2. Etc. Etc.
Frequency of Supervisory Board meetings held within 1 (one) month.
No Name Position Number of Supervisory Board Meetings (... meetings) Number of Attendees % Attendance Physical Teleconference/Video/Conference/Other Electronic Media Facilities 1. 2. Etc.
Family relationships between Supervisory Board members and members of other Supervisory Boards, DPPK Management Board members, and/or Acting Management Board members at the Pension Fund where the Supervisory Board member in question serves.
No. Name Family Relationship with Other Supervisory Board Members DPPK Management Board Members Acting Management Board Members Yes No Ket* Yes No Ket* Yes No Ket* 1. 2. Etc.

Note:
*) Form of family relationship: spouse/child/parent/sibling/in-law, etc.

c. Supervisory Board Supervision Results Report

Supervisory Board activity report on the application of Pension Fund Governance
Summary of Supervision Results Recommendations

d. Committees

Functions under the DPPK Management Board
No. Name Function Member Name Position* Length of Service Appointment Decree Number of Meetings per Year 1. Internal Audit Function 1. 2. Etc. 2. Risk Management Function 1. 2. Etc.

Compliance Function

Etc.
Etc.

Committees under the Supervisory Board
No. Name Committee Member Name Position* Length of Service Appointment Decree Number of Meetings per Year 1. Audit Committee 1. 2. Etc. 2. Risk Monitoring Committee 1. 2. Etc.

Nomination and Remuneration Committee

Etc.
Etc.

e. Application of external auditor functions.
No. Description Year n-2 Year n-1 Year n

Name of Public Accounting Firm
Name of Public Accountant
Audit Period
Appointment by Supervisory Board

f. Application of remuneration and other facility policies for DPPK Management Board members, Supervisory Board members, and Employees. The number of DPPK Management Board members, Supervisory Board members, and Employees receiving remuneration packages in 1 (one) year, grouped by income level as follows:
Remuneration Amount per Person per Year *) Number of DPPK Management 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: *) requested in cash

g. Outsourcing of Investment Management No. Type of Investment Name of Outsourcing Company Investment Value Agreement No. % of Total Investment Portfolio 1. 2. Etc.

h. Disclosure of other important matters. Disclosure of other important matters No. Description Checklist *) If Yes, Explain Yes No

Resignation or dismissal of external auditor
Material transactions with related parties
Conflicts of interest currently ongoing and/or likely to occur
Other material information regarding the Pension Fund
The Pension Fund has a compliance function
The Pension Fund has an internal auditor
The Pension Fund has a risk management function
The Company has an investment management function/unit

No. Description Checklist *) If Yes, Explain Yes No
10. The Company has a special work unit and/or appoints a PJK official responsible for the implementation of AML and CFT programs
*) choose one answer by marking with a “√” ) Related Parties are individuals or companies/entities that have a controlling relationship with the Pension Fund, directly or indirectly, through ownership, management, and/or financial relationships.

Self-Assessment of the Application of Good Pension Fund Governance
The completion of the Good Pension Fund Governance Application questionnaire is conducted by the respective Pension Fund. This questionnaire is completed by providing answers to the questions/statements in the questionnaire.

Completion Method:
Generally, answers to the Questions/Statements consist of 5 criteria as follows (except for answers requiring different criteria):
A = The respective Pension Fund DOES NOT HAVE a written policy regarding the Question/Statement in question. B = The respective Pension Fund HAS a written policy regarding the Question/Statement in question, but the policy has NOT been implemented. C = The respective Pension Fund HAS a written policy regarding the Question/Statement in question, but the policy has NOT been implemented CONSISTENTLY. D = The respective Pension Fund HAS a written policy regarding the Question/Statement in question, the policy is IMPLEMENTED CONSISTENTLY but has NOT been UPDATED regularly. E = The respective Pension Fund HAS a written policy regarding the Question/Statement in question and the policy is IMPLEMENTED CONSISTENTLY and UPDATED regularly.

Interpretation of Results
An assessment is required to interpret the score obtained in answering the questions of this Questionnaire, the majority of which consist of 5 (five) scales from the lowest assessment (A/No) to the highest assessment (E/Yes). Specifically, for answers of "A/No" on assessment criteria required by statutory regulations (mandatory), a negative score is given.

For groups of Questions/Statements skipped due to "None" and which are not "not applicable", the interpretation of results must still be calculated by giving the same score as the answer "A/No".

I. 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 among others:
2.1. General policy directing to statutory regulations 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 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. 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, the Management Board, Supervisory Board, and pension fund employees:
5.1. Make a statement of "no conflict of interest" regarding every decision taken by the authorized party No Yes
5.2. Make an annual statement regarding the implementation of the company's code of conduct No Yes
5.3. Make an annual statement not to receive or give anything that could influence decision-making No Yes
The Pension Fund correctly records its assets, liabilities, and own capital (equity) using generally accepted accounting principles or specific accounting principles for pension funds No Yes
Has a complaint system regarding violations of the code of conduct, Pension Fund regulations, and statutory regulations, and matters related to Participants, which ensures protection for the Whistleblower. A B C D E

II. PENSION FUND ORGANS

A. Founder and Co-Founder

The Founder and Co-Founder, according to their respective functions, have carried out the following:
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. Follow-up on audit findings and recommendations from the work units performing the functions of the Pension Fund's internal auditor, external auditor, and/or the results of supervision by the Financial Services Authority (OJK) A B C D E

B. Management Board

Composition of Appointment and Dismissal of Management Board Members
1.1. The number of Management Board members has been adjusted to the complexity of the company while still considering the effectiveness of decision-making. No Yes
1.2. The Management Board consists of members who collectively possess competencies*) such as:
1.2.a Investment Field No Yes
1.2.b Risk Management Field. No Yes
Management Board Requirements
2.1. Management Board members meet the articles of association requirements No Yes
2.2. Management Board members meet the competency and propriety requirements according to the regulations of the supervisory authority No Yes
2.3. Management Board members must understand and implement GCG A B C D E
2.4. Management Board members are prohibited from utilizing the Pension Fund for personal, family, business group, or other parties' interests that harm the Pension Fund's interests No Yes
2.5. Do not hold concurrent positions as members of the Supervisory Board or DPS at the same Pension Fund No Yes
2.6. Do not hold concurrent positions as directors or commissioners or equivalent at other companies and/or institutions No Yes
2.7. Management Board members do not hold concurrent positions as members of the Management Board, Acting Management Board, Supervisory Board, or DPS at other Pension Funds. No Yes
Management Board Functions
3.1. Management
3.1.1. The Management Board is fully responsible for the management of the Pension Fund A B C D E
3.1.2. The Management Board manages the resources owned, 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. The Management Board considers the fair interests of stakeholders A B C D E
3.1.4. The Management Board has and complies with meeting rules and working guidelines (charters) regulated in the PDP and statutory regulations in the field of Pension Funds A B C D E
3.1.5. The Management Board member overseeing the compliance function cannot be held concurrently by the Management Board member overseeing the funding, finance, or investment functions, unless the number of Management Board members is 2 (two), in which case the compliance function can be held concurrently by the Management Board member overseeing the finance function No Yes
3.2. Risk Management
4.2.1. The Management Board formulates and implements a Risk Management System covering all aspects of the Pension Fund's activities A B C D E
4.2.2. The Pension Fund has a Risk Monitoring Committee and a Risk Management Work Unit No Yes
3.3. Internal Control
4.3.1. The Pension Fund has an internal supervision function No Yes
4.3.2. Responsible for the execution of its duties to the Founder and Co-Founder No Yes
3.4. Information Technology
4.4.1. The Company has an integrated computerized administration system A B C D E
4.4.2. The Company has Standard Operating Procedures for the Information Technology department A B C D E
Management Board Accountability
4.1. The Management Board prepares a report on the accountability of Pension Fund management in the form of an Annual Report No Yes
4.2. Criteria for the Annual Report include:
4.2.1. Contains at least:
a. Financial Report No Yes b. Pension Fund Activity Report No Yes
c. GCG Implementation Report No Yes
4.2.2. Receives approval from the Founder and Co-Founder No Yes
4.2.3. Specifically, the financial report must receive ratification from the Founder and Co-Founder No Yes
4.3. Management Board Meetings
4.3.1. Every strategic policy and decision must be decided through a DPPK Management Board meeting, considering supervision according to the duties and responsibilities of the Supervisory Board No Yes
4.3.2. The Management Board holds meetings regularly at least 1 (one) time in 1 (one) month No Yes
4.3.3. The Management Board establishes meeting rules No Yes
4.3.4. Every Management Board meeting creates meeting minutes No Yes
4.3.5. Meeting minutes include dissenting opinions with the decisions taken in the meeting (if any) A B C D E
4.3.6. Every Management Board member, whether attending or not, has the right to receive the Management Board Meeting Minutes No Yes

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 Company while still considering the effectiveness of decision-making No Yes
1.2. All Supervisory Board members consist of members who collectively possess competencies relevant to their positions No Yes
1.3. Do not hold concurrent positions as Management Board or DPS at the same DDPK, or Supervisory Board, Management Board, or DPS at other DPPKs No Yes
Competency and Integrity of the Supervisory Board
2.1. Meet the Fit and Proper Test requirements No Yes
2.2. Monitor the effectiveness of the application of Pension Fund GCG A B C D E
2.3. Do not utilize the Pension Fund for personal, family, business group, or other parties' interests that can harm the Pension Fund. No Yes
Supervisory Board Supervision Functions
3.1. Fully responsible for the supervision of DPPK A B C D E
3.2. Carry out the duties and responsibilities of the Supervisory Board as regulated in the PDP and statutory regulations in the field of Pension Funds independently No Yes
3.3. The Supervisory Board holds meetings regularly No Yes
3.4. Every Supervisory Board meeting creates meeting minutes No Yes
3.5. Meeting minutes include dissenting opinions with the decisions taken in the meeting A B C D E
3.6. Every Supervisory Board member, whether attending or not, has the right to receive the Supervisory Board Meeting Minutes No Yes
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 well A B C D E
4.1.2. Internal audit is carried out according to applicable audit standards A B C D E
4.1.3. Follow-up on internal audit findings is carried out by management. A B C D E
4.1.4. External audit has been carried out according to applicable auditing standards No Yes
4.1.5. Follow-up on external audit findings is carried out 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, management, and/or family relationships with the Supervisory Board, DPPK Management Board, and/or Founder, or other relationships that could influence their ability to act independently. No Yes
4.1.7. For Pension Funds that do not have an Audit Committee, there is a Supervisory Board member who specifically has the duty to ensure the following:
a. The Pension Fund's internal control structure has been implemented well A B C D E b. Internal audit implementation is carried out according to applicable auditing standards A B C D E
c. Follow-up on internal audit findings is carried out by management. A B C D E
d. External audit implementation has been carried out according to applicable auditing standards No Yes e. Follow-up on external audit findings is carried out 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 the Management Board. 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 Companies that do not have a Risk Monitoring Committee, there is a Supervisory Board member who specifically has the duty 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 the Board of Directors.

A B C D E

4.3. Nomination and Remuneration Committee
Not
Yes
Continue to 4.3.4.

The Nomination and Remuneration Committee serves as a facilitator for the Board of Commissioners for the following matters:

4.3.1. Facilitator for the Board of Commissioners in assisting the Founder in setting criteria and selecting candidates for the Board of Commissioners and Board of Directors of the Pension Fund
A B C D E

4.3.2. Facilitator for the Board of Commissioners in assisting the Founder in setting the remuneration system
A B C D E

4.3.3. Members of the Nomination and Remuneration Committee consist of:
a. Board of Commissioners members Yes No b. Other parties Yes No

4.3.4. For Pension Funds that do not have a Nomination and Remuneration Committee, there are Board of Commissioners members who specifically serve the following functions:
a. Assist the Founder in setting criteria and selecting candidates for the Board of Commissioners and Board of Directors of the Pension Fund A B C D E b. Assist the Founder in setting the remuneration system A B C D E

III. GOOD BUSINESS PRACTICES
A. External Auditor

External Auditor (public accounting firm) conducts an independent examination of the truthfulness of the Pension Fund's financial reports
Not Yes
The appointed public accounting firm (KAP) is registered with the Financial Services Authority
Not Yes
Action Plan
No.
Corrective Action
Target Completion
Completion Obstacles
Remarks

...

Implementation of Anti-Fraud Strategy
(Pension Fund Name)..............................
FRAUD CONTROL REPORT AND ANTI-FRAUD STRATEGY IMPLEMENTATION YEAR …… a. Inventory of Fraud Incidents and Follow-up Type Fraud a) Date of Fraud Division/Department of Fraud Party Involved b) Position Loss in Rupiah c) Company Actions d) Weaknesses/ Causes of Fraud e) Follow-up/ Improvement f) Chronology of Fraud g) b. Progress of Anti-Fraud Strategy Implementation

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

VII. Evidence of Fulfillment of Continuity Requirements for Directors and Employees Handling Investment
FORM :
FORM SELF ASSESSMENT
REPORT ON FULFILLMENT OF CONTINUITY REQUIREMENTS FOR DIRECTORS AND EMPLOYEES HANDLING INVESTMENT Pension Fund Name :
Report Letter Number :
Report Letter Date :
Contact Person (Name,
Tel/email)
:
NO DESCRIPTION LEGAL BASIS YES NO REMARKS 1.
The continuity requirement fulfillment report is submitted by the Pension Fund Board of Directors to the OJK no later than 1 (one) month after the annual period ends. o POJK 3/POJK.05/2015 o POJK 5/POJK.05/2018
2. Evidence of fulfillment of continuity requirements
Additional remarks (if necessary):
No Name
Type
Principal Party *)
No. and date of FPT SK
Type of Fulfillment *)
Title of Activity
Organizer of Activity
*)
Name of Organizer
Date of Implementation
Year of Fulfillment
Evidence of Fulfillment *)
..... o Board of Directors o Employee ..... o attending seminar, workshop, or similar activities o attending courses, training, or similar educational programs o writing papers, articles, or other published written works o becoming a speaker in seminar, workshop, or similar activities, becoming an instructor or becoming an instructor in course, training, or similar educational programs ..... o financial services supervisory agency inside and outside the country o association of financial services institutions inside and outside the country o higher education institutions inside and outside the country o training institutions that have obtained a license from the competent authority ..... ..... ..... o certificate (number and date) o attendance proof
o others, namely.....
Remarks:

Filling method: click twice in the box, then select "Checked"
*) Select one
This Self Assessment Form is prepared based on the provisions of OJK Regulation No. 3/POJK.05/2015 Concerning Pension Fund Investment
Types of fulfillment of continuity requirements related to knowledge in the field of investment and/or risk management as regulated in OJK Regulation No. 3/POJK.05/2015 Concerning Pension Fund Investment

FORMAT I D
A. Report on Consumer Complaint Services and Resolution by Financial Service Business Actors The form and structure of the consumer complaint report and follow-up on consumer service and resolution as referred to in the Financial Services Authority Regulation concerning 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 concerning Services and Resolution of Consumer Complaints by Financial Service Business Actors. B. Report on the Appointment of Public Accountants and/or Public Accounting Firms in the Context of Audits on 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 audits on annual historical financial information as referred to in the Financial Services Authority Regulation concerning the Use of Public Accountants and Public Accounting Firms in Financial Services Activities refers to the form and structure as contained in the Appendix of the Financial Services Authority Circular Letter concerning Procedures for the Use of Public Accountants and Public Accounting Firms in Financial Services Activities.
C. Report on the Audit Committee's Evaluation Results Regarding the Implementation of Audit Services on 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 on annual historical financial information by public accountants and/or public accounting firms as referred to in the Financial Services Authority Regulation concerning the Use of Public Accountants and Public Accounting Firms in Financial Services Activities refers to the form and structure as contained in the Appendix of the Financial Services Authority Circular Letter concerning Procedures for the Use of Public Accountants and Public Accounting Firms in Financial Services Activities.

D. Periodic Actuarial Report
A. Actuarial Report for Employer Pension Funds Administering Defined Benefit Pension Programs General Data Report Number Report Date Company Code Company Name Company Address Reporting Period Reporting Month Fiscal Year Type of Reporting Period Annual Report Board of Directors Name Board of Directors Position

Actuarial Statement
1.1 Company Actuarial Information:

Actuarial Name;
Office Address and Telephone Number;
1.2 Statement regarding Actuarial Present Value, Solvency Liability, Funding Wealth, Surplus or Deficit, Solvency Ratio, Funding Ratio, and funding quality.
1.3 Statement regarding:

the amount of Normal Contributions to be paid until the end of the first fiscal 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 earnings for years after the fiscal 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
1.4 Statement regarding the amount of Additional Monthly Contributions and their payment period.
1.5 Pension Cost Sharing
I, the undersigned, declare that:
for the Periodic Actuarial Report as referred to in the Financial Services Authority Regulation concerning Pension Fund Funding
All data received is complete, and can be accounted for for the purpose of preparing the Actuarial Report to the best of the actuary's knowledge, and for that purpose, testing has been conducted to assess its reliability.
The Report has met the provisions of laws and regulations in the field of Pension Funds.
The Report has met the Employer's provisions.
The Report has been prepared based on the PDP; and
The Report has been prepared based on actuarial practice standards for Pension Funds applicable in Indonesia;
Place, date of creation
Signature.
Name
No. Indonesia Actuarial Association (PAI) Register Public Actuary License No.:
Founder/Partner Founder Statement
We, the undersigned, declare that:
the data and PDP submitted are complete and correct;
we are able to pay contributions in accordance with the minimum funding stated in the Actuarial Statement; and
in the event of a surplus, it is used to reduce Employer Normal Contributions, including representing the statement of all employers in the case of sharing/non-sharing pension cost
Place, date of creation Position*) Signature.
Name
Actuarial Valuation Date
Actuarial valuation date reported
Actuarial valuation date of previous period
Purpose of Preparation
Summary of PDP and Changes occurring in the PDP since the previous actuarial valuation date
Summary of the number of Participants and number of beneficiaries and changes occurring since the previous actuarial valuation date
Actuarial Valuation Method and Actuarial Assumptions Used
Actuarial valuation method and actuarial assumptions used Data Description Actuarial Calculation Method Actuarial 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 service Mortality rate during retirement Disability rate Withdrawal rate Other Assumptions Tax (in case tax on pension benefits is borne by the Pension Fund) Age difference between husband and wife 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
Data Description a. Funding Wealth Value Wealth - Funding wealth Liabilities - Solvency Liability Actuarial Present Value b. Analysis of Surplus or Deficit Changes Funding Position Surplus Surplus excess Surplus usage period Total Deficit Pre-law deficit Deficit categorized as solvency deficiency External deficit categorized as solvency deficiency Analysis:
Funding quality level
Funding Ratio
Solvency Ratio
CONTRIBUTIONS

Normal Contribution

First Year (Rp)
Subsequent Years 0.00%
Participant Normal Contribution (%) Employer Normal Contribution (%) Total Additional Contribution - Monthly Contribution Installment period (months)
c. Overall Actuarial Valuation Results
Actuarial valuation date reported:
Actuarial valuation date previous:
9. Monthly Actuarial Present Value Projection for at least the first 3 (three) years

Name and address of the Actuary and explanation of whether the Actuary also signed the Actuarial Statement in the previous Actuarial Report
B. Actuarial Report for Pension Funds Administering Defined Contribution Pension Programs and Making Periodic Pension Benefit Payments General Data Report Number Report Date Company Code Company Name Company Address Reporting Period Reporting Month Fiscal Year Type of Reporting Period Annual Report Board of Directors Name Board of Directors Position
Actuarial Statement
1.1 Company Actuarial Information:

Actuarial Name;
Office Address and Telephone Number;
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 the actuary's knowledge, and for that purpose, testing has been conducted to assess its reliability.
The Report has met the provisions of laws and regulations in the field of Pension Funds.
The Report has met the Employer's provisions.
The Report has been prepared based on the PDP; and
The Report has been prepared based on actuarial practice standards for Pension Funds applicable in Indonesia;
Place, date of creation
Signature.
Name
No. Indonesia Actuarial Association (PAI) Register Public Actuary License No.:
Actuarial Valuation Date
Actuarial valuation date reported
Actuarial valuation date of previous period
Purpose of Preparation
Summary of PDP including payment pattern and normal retirement age
Summary of the number of Participants, widows/widowers, and children choosing periodic Pension Benefit payments
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 Administering Other Defined Benefits Programs
General Data
Report Number
Report Date
Company Code
Company Name
Company Address
Reporting Period
Reporting Month
Fiscal Year
Type of Reporting Period Annual Report Board of Directors Name Board of Directors Position

Actuarial Statement
1.1 Company Actuarial Information:

Actuarial Name;
Office Address and Telephone Number;
1.2 Statement regarding the program asset value of Other Defined Benefits, present value of potential Other Benefits payments, and adequacy of Other Defined Benefits funding.
1.3 Statement regarding the amount of funding required for the administration of Other Defined Benefits
1.4 Pension Cost Sharing
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 the actuary's knowledge, and for that purpose, testing has been conducted to assess its reliability.
The Report has met the provisions of laws and regulations in the field of Pension Funds.
The Report has met the Employer's provisions.
The Report has been prepared based on the PDP; and
The Report has been prepared based on actuarial practice standards for Pension Funds applicable in Indonesia;
Place, date of creation
Signature.
Name
No. Indonesia Actuarial Association (PAI) Register Public Actuary License No.:
Founder/Partner Founder Statement
We, the undersigned, declare that:
The data and PDP submitted are complete and correct;
We are able to pay contributions in accordance with the minimum funding stated in the Actuarial Statement; and
In the event of Other Defined Benefits funding excess, it is used to reduce Other Defined Benefits contributions, including representing the statement of all employers in the case of sharing/non-sharing pension cost.
Place, date of creation Position*) Signature.
Name
Actuarial Valuation Date
Actuarial valuation date reported
Actuarial valuation date of previous period
Purpose of Preparation
Summary of PDP and Changes occurring in the PDP since the previous actuarial valuation date
Summary of the number of Participants and number of beneficiaries of Other Benefits along with changes occurring since the previous actuarial valuation date
Actuarial Valuation Method and Actuarial Assumptions Used
Actuarial valuation method and actuarial assumptions used Data Description Actuarial Calculation Method Actuarial 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 service Mortality rate during retirement Disability rate Withdrawal rate Other Assumptions Tax (in case tax on pension benefits is borne by the Pension Fund) Age difference between husband and wife 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
8. Overall Actuarial Valuation Results
Actuarial Calculation Results
Data Description a. Funding Wealth Value Wealth - Funding wealth Liabilities - Solvency Liability Actuarial Present Value b. Analysis of Surplus or Deficit Changes Funding Position Surplus Surplus excess Surplus usage period Total Deficit Pre-law deficit Deficit categorized as solvency deficiency External deficit categorized as solvency deficiency Funding 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
Actuarial valuation date reported:
Actuarial valuation date previous:
9. Program asset value of Other Defined Benefits
10. Description of the determination of Other Defined Benefits program asset value
11. Analysis of changes in Other Defined Benefits funding adequacy
12. Projection of present value of potential Other Benefits payments semi-annually for at least the first 3 (three) years

E. Pension Fund Business Plan
A. Executive Summary

Financial Indicators
No. Description
Projection
Millions of Rupiah % Growth
1 Assets
2 Investments
3 Liabilities
4 Investment Income
5 Investment Expenses
6 Investment Business Results
7 Operational Expenses
8 Business Results Before Tax
9 Business Results After Tax
Financial Ratios
No. Description %
1 Investment Income Ratio (ROI)
2 Investment Income to Assets Ratio (ROA) 3 Operational Expense Ratio (BOPO)
Non-Financial Executive Summary
The non-financial executive summary contains a summary of information regarding Company targets for 1 (one) to 3 (three) years ahead that the Pension Fund deems very necessary to include in the executive summary. B. Evaluation of Previous Business Plan Implementation Indicator 20XX-1 20XX-2 20XX-3 Plan Realization % Plan Realizatio n % Plan Realizatio n % Plan Realizatio n % (1) (2) (1/2) (1) (2) (1/2) (1) (2) (1/2) Investment Income Ratio (ROI) for the Pension Fund business plan as referred to in the Financial Services Authority regulation concerning good governance for Pension Funds

Indicator
20XX-1 20XX-2 20XX-3
Plan Realization %
Plan
Realizatio n
%
Plan
Realizatio n
%
Plan
Realizatio n
%
(1) (2) (1/2) (1) (2) (1/2) (1) (2) (1/2) Investment Income Ratio to Assets (ROA) Operational Expense Ratio (BOPO) Funding Adequacy Ratio
C. Vision, Mission, Business Strategy, and Management Policy
Completed with targets to be achieved for 1 (one) to 3 (three) years ahead accompanied by policies and strategies to be implemented.

Vision and mission
Business Strategy and Management Policy
No. Target Policy Strategy

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

D. Implementation of Risk Management and Compliance Scope of Implementation Risk Management Description Active Supervision Board of Directors, Acting Board of Directors, and Board of Commissioners …………… (Filled with description of the role of the Board of Directors, Acting Board of Directors, and Board of Commissioners in Risk Management and Risk Management organizational structure) Adequacy of Policies, Procedures, and Risk Limit Setting …………… (Filled with description of risk appetite, risk tolerance, and Risk limit setting) Adequacy of the Identification, Measurement, Monitoring, and Risk Control Process …………… (Filled with description of the identification, measurement, monitoring, and risk control process) Risk Management Information System …………… (Filled with description of how the pension fund information system supports the implementation of Risk Management) Comprehensive Internal Control System …………… (Filled with description of how internal control including the compliance function is conducted by the pension fund) E. Implementation of Pension Fund Governance

Pension Fund Governance Implementation Plan
Action Plan
No.
Corrective Action
Target
Completion
Completion Obstacles
Remarks

...

Anti-Fraud Strategy Implementation Plan
F. Current and Previous Period Pension Fund Financial Performance
Investment Income
No.
RKAP
Year n-1
RKAP
Year n
Actual as of
September
Year n
%
Achievement
% Increase (Decrease) against RKAP Year n-1 1 2 3 4 5=4/3 6=(5-4)/4
Investment Business Results
No.
Type of
Investment
Investment Business Results
RKAP
Year n-1
RKAP
Year n
Actual as of 30
September
Year n
%
Achievement
% Increase
(Decrease) against
RKAP Year n-1
1 2 3 4 5 6=5/4 7=(4-3)/3
Business Results
No. Profit
RKAP
Year n-1
RKAP
Year n
Actual as of 30
September
Year n
%
Achievement
% Increase
(Decrease) against
RKAP Year n-1
1 2 3 4 5 6=5/4 7=(4-3)/3
Business Results
Before
Tax
Business Results
After Tax

G. Financial Statement Projections and Assumptions Used

Financial Position Projection for Pension Funds
(in millions of Rupiah)
DESCRIPTION
Actual as of 30
Sept
20XX1*
Projection as of 31
Dec
20XX-1*
Projection
Year 1
Projection as of 31
Mar
20XX* as of 30
Jun
20XX* as of 30
Sep
20XX* as of 31
Dec
20XX* as of 31
Dec
20XX
+1* as of 31
Dec
20XX+
ASSETS
INVESTMENTS
Savings in Banks
On-call
Deposits in Banks
Fixed-term
Deposits in Banks
Certificates of Deposit in Banks
Securities
Issued by Bank
Indonesia
Government
Securities
Stocks
Listed on the Indonesian
Stock Exchange

Corporate
Bonds
Listed on the Indonesian
Stock Exchange

DESCRIPTION
Actual as of 30
Sept
20XX1*
Projection as of 31
Dec
20XX-1*
Projection
Year 1
Projection as of 31
Mar
20XX* as of 30
Jun
20XX* as of 30
Sep
20XX* as of 31
Dec
20XX* as of 31
Dec
20XX
+1* as of 31
Dec
20XX+
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 futures contracts for securities Listed on the Indonesian Stock Exchange

Land in
Indonesia

Buildings in Indonesia

Land and
Buildings in Indonesia

TOTAL
INVESTMENTS

CURRENT ASSETS
OUTSIDE
INVESTMENTS

Cash and
Banks

Contribution
Receivables

Interest
Receivables
Late
Contribution
Fees

Prepaid
Expenses

Investment
Receivables

Investment
Income
Receivables

Other
Receivables

OPERATIONAL
ASSETS

Land and
Buildings

Vehicles -
Computer
Equipment

Office
Equipment

Other
Operational
Assets

Accumulated
Depreciation
TOTAL
OPERATIONAL
ASSETS

OTHER ASSETS

ASSETS
AVAILABLE

LIABILITIES - - - -
Liabilities
Outside
Pension
Benefit
Liabilities
Pension
Benefit
Liabilities

DESCRIPTION
Actual as of 30
Sept
20XX1*
Projection as of 31
Dec
20XX-1*
Projection
Year 1
Projection as of 31
Mar
20XX*
Projection as of 30
Jun
20XX*
Projection as of 30
Sep
20XX*
Projection as of 31
Dec
20XX*
Projection as of 31
Dec
20XX
+1*
Projection as of 31
Dec
20XX+
Pension and
Other Benefits Due
Liabilities
Investment
Liabilities

Other
Liabilities
Total
Liabilities outside
Pension
Benefit
Liabilities
TOTAL
LIABILITIES
NET ASSETS
Note:
If the business plan submission is for the years 2015 - 2017, then 20XX-1 is the year 2014 (current year), 20XX is the year 2015, etc. If the description below has no figures related to SAP, it is entered manually in the ratio:
2. Projection of the Statement of Comprehensive Income
(in millions of rupiah)
DESCRIPTION
Actual
Actual
Projection
Projection
Year 1
Jan-Sept
Jan-Dec
Jan-Mar
20XX
Jan-Jun
20XX*
Jan-Sep
20XX*
Jan-Dec
20XX*
Jan-Dec
20XX
+1*
Jan-31
Dec
20XX+
20XX1*
20XX1*
INVESTMENT
INCOME
Interest/Share of Profit
Dividends
Rent
Profit (Loss) from Investment
Disposal

DESCRIPTION
Actual
Actual
Projection
Projection
Year 1
Jan-Sept
Jan-Dec
Jan-Mar
20XX*
Jan-Jun
20XX*
Jan-Sep
20XX*
Jan-Dec
20XX*
Jan-Dec
20XX
+1*
Jan-31
Dec
20XX+
20XX1*
20XX1*
Other Investment
Income

Total
Investment
Income
INVESTMENT
EXPENSES
Transaction
Expenses
Maintenance
Expenses for Land and
Buildings

Depreciation
Expenses for Buildings

Investment
Manager
Expenses
Custodian
Expenses
Other Investment
Expenses
Total Investment
Expenses
INVESTMENT
RESULTS

OPERATIONAL
EXPENSES

Salaries/Honoraria for Employees,
Managers, and
Supervisory Board
Office Expenses

Maintenance
Expenses
Depreciation
Expenses
Third-Party Service
Expenses
Other Operational
Expenses
Total Operational
Expenses
OTHER INCOME
AND EXPENSES

Late Payment
Interest
Profit (Loss) from Sale of
Operational Assets

DESCRIPTION
Actual
Actual
Projection
Projection
Year 1
Jan-Sept
Jan-Dec
Jan-Mar
20XX*
Jan-Jun
20XX*
Jan-Sep
20XX*
Jan-Dec
20XX*
Jan-Dec
20XX
+1*
Jan-31
Dec
20XX+
20XX1*
20XX1*
Profit (Loss) from Sale of
Other Assets

Other Income
Outside
Investment
Other Expenses
Outside
Investment and
Operational
Total
Other Income and Expenses
INCOME BEFORE
TAX
INCOME
TAX
INCOME AFTER
TAX
Note:
If the business plan submission is for the years 2015 - 2017, then 20XX-1 is the year 2014 (current year), 20XX is the year 2015, etc.
3. Projection of Ratios and Other Specific Items for Pension Funds
(in millions of rupiah)
(ratios in percentage)
DESCRIPTION
Actual
Projection
Year 1
Jan-Sept
Jan-Dec
Jan-Mar
20XX
*
Jan-Jun
20XX
Jan-Sep
20XX*
Jan-Dec
20XX
*
Jan-Dec
20XX
+1*
Jan-Dec
20XX
+2*
20XX1*
20XX1*
Investment Income
Ratio (ROI)
Investment Income
Ratio against Assets
(ROA)
Operational Expense
Ratio (BOPO)
Fund Sufficiency
Ratio

Note:
*If the business plan submission is for the years 2015 - 2017, then 20XX-1 is the year 2014 (current year), 20XX is the year 2015, etc. If there are accounts that must be filled from cumulative calculations, e.g., from the income statement, they are filled with cumulative values.
4. Assumptions Used
H. Pension Fund Plan

Funding Plan
The funding plan generally comes from contributions as well as the results of their development. Contributions can be made by the employer alone or jointly between the employer and the employee (participant). No. DESCRIPTION Actual Proj ection Projection Projection Year 1 Jan-Sept Jan-Dec Jan-Mar 20X X 2 Jan-Jun 20X X 2 Jan-Sep 20X X 2 Jan-Dec 20X X 2 Jan-Dec 20XX +1 3 Jan-Dec 20XX +2 3 20XX1 1 20X X-1 Assumption of Interest Rate 2 Assumption of Actuarial Calculation Method 3 Assumption of Mortality Rate 4 Investment return rate 5 etc. (other relevant assumptions)

DESCRIPTION
Actual
Projection
Year 1
As of 30
Sept
As of 31
Dec
As of 31
Mar
20XX
As of 30
Jun
20XX
As of 30
Sep
20XX*
As of 31
Dec
20XX
As of 31
Dec
20XX+
As of 31
Dec
20XX+
20XX-1 20XX-1
FUNDS
CONTRIBUTIONS
Employer
(filled with nominal)
Participant
Total
Contribution
Funds
Note:
*If the business plan submission is for the years 2015 - 2017, then 20XX-1 is the year 2014 (current year), 20XX is the year 2015, etc.
2. Investment Plan
a. Investment Composition
No.
Type of investment
Actual
Projection
Year 1
As of 30
Sept
As of 31
Dec
As of
Mar
20XX
As of
Jun
20XX
As of
Sep
20XX
*
As of
Dec
20XX
As of 31
Dec
20XX+
As of 31
Dec
20XX+
20XX-1 20XX-1
Etc. b. Investment Results
No.
Type of investment
Actual
Projection
Year 1
As of 30
Sept
As of 31
Dec
As of
Mar
20XX
As of
Jun
20XX
As of
Sep
20XX
*
As of
Dec
20XX
As of
Dec
20XX
+1
As of 31
Dec
20XX+
20XX-1 20XX-1
Etc.

Organizational and Human Resources Development Plan
a. Plan for HR quantity requirements No Level Position Number of HR as of 30 Sept 20XX-1 Recruitment to be Carried Out Quarter IV 20XX-1 Quarter I 20XX Quarter II 20XX Quarter III 20XX Quarter IV 20XX Addition Reorg Addition Reorg Addition Reorg Addition Reorg Addition Reduction Etc Total b. Plan for HR Education and Training Implementation for Managers, Acting Managers, and the Supervisory Board No Material/Topic Participant Training Time Etc
Plan for Office Network Development and/or Changes
The plan for office network development and/or changes must at least include plans for opening and merging offices outside the head office. No Type of office Implementation Time 1 Location 2 Note 3 A. Opening B. Status Change
C. Merger
D. Address Relocation
Etc

No
Type of office
Implementation
Time 1
Location 2
Note 3
E. Office Closure
Etc
Note:
1 Filled with the month of the planned implementation time. 2 For locations in the DKI Jakarta region, at least the name of the DKI Jakarta province must be mentioned. For locations outside the DKI Jakarta region, at least the name of the Regency/City must be included. 3 Detailed notes can be attached in a separate sheet.

This copy is consistent with the original Legal Director 1 Legal Department signed Yuliana A. Information Technology System Development Plan Detail the plan for the use of information technology used by the company to support business activities. No Type/Name of Application Ownership (In-house/vendor) Vendor Name Application Function B. Other Information Other information must at least include information that needs to be disclosed because it affects the business activities of the Pension Fund, which is not mentioned in the scope of the Business Plan. Examples:

merger and separation plans;
portfolio transfer plans;
plans to change business activities not based on Sharia principles to
based on Sharia principles.
Determined in Jakarta on March 5, 2019 EXECUTIVE HEAD OF SUPERVISOR OF INSURANCE, PENSION FUNDS, FINANCING INSTITUTIONS, AND OTHER FINANCIAL SERVICES INSTITUTIONS FINANCIAL SERVICES AUTHORITY, signed RISWINANDI

APPENDIX II
CIRCULAR LETTER OF THE FINANCIAL SERVICES AUTHORITY NUMBER 3 /SEOJK.05/2019 REGARDING THE FORM AND STRUCTURE OF PERIODIC REPORTS FOR PENSION FUNDS

FORMAT II A
To
The Directorate of Statistics and Information IKNB Financial Services Authority MONTHLY REPORT / ANNUAL FINANCIAL REPORT ELECTRONIC DATA PENSION FUND FINANCIAL INSTITUTION 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
Manager Name
Manager Position
SID Number
Audit Data
Auditor License SK
Audit Type
Auditor Code
Auditor Name
Opinion
Audit Executor
Audit Date
Report Compiler
Officer Name
Division
Phone
Fax
Email
Responsible Manager
Responsible Person Name
Position
Phone
Fax
E-mail
Pension Fund Address

Description Details
Code
Percentage
Pension Program
Other Benefits
Combined
ASSETS
INVESTMENT
Bank Savings 1101
On-call Deposits at Banks 1102
Term Deposits at Banks 1103
Bank Deposit Certificates 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 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 INVESTMENT CURRENT ASSETS OUTSIDE INVESTMENT Cash and Bank 1201 Prepaid Expenses 1204 Investment Receivables 1205 Investment Income Receivables 1206 Other Receivables 1207 TOTAL CURRENT ASSETS OUTSIDE INVESTMENT AVAILABLE ASSETS LIABILITIES Liabilities outside Pension Benefit Liabilities Pension Benefit and Other Benefits Payable 1501 Voluntary Benefit Payable 1502 Investment Payable 1503 Unearned Revenue 1504 Accrued Expenses 1505 Other Payables 1506 Total Liabilities outside Pension Benefit Liabilities TOTAL LIABILITIES NET ASSETS DEFINED CONTRIBUTION PENSION PROGRAM NET ASSET STATEMENT As of DD-MM-YYYY

Defined Contribution Pension Program Other Benefits Combined ADDITIONS Investment Income Interest/Share of Profit 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 DEDUCTIONS Investment Expenses 405 Operational Expenses 406 Expenses Outside Investment and Operational 407 Pension Benefits and Other Benefits Income Tax 408 Transfer of Funds to Other Pension Funds 409 Contribution Withdrawals Total Deductions INCREASE (DECREASE) IN NET ASSETS NET ASSETS AT BEGINNING OF PERIOD NET ASSETS AT END OF PERIOD DEFINED CONTRIBUTION PENSION PROGRAM STATEMENT OF CHANGES IN NET ASSETS As of DD-MM-YYYY Description Details Code Accumulation as of DD-MM-YYYY

Defined Contribution Pension Program Other Benefits Combined ASSETS INVESTMENT (Historical Value) Bank Savings On-call Deposits at Banks Term Deposits at Banks Bank Deposit Certificates 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 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 Building Depreciation TOTAL INVESTMENT INVESTMENT VALUATION DIFFERENCE CURRENT ASSETS OUTSIDE INVESTMENT Cash and Bank Prepaid Expenses Investment Receivables Investment Income Receivables Other Receivables TOTAL CURRENT ASSETS OUTSIDE INVESTMENT TOTAL ASSETS LIABILITIES PENSION BENEFIT LIABILITIES Accumulated Contributions Operating Results Transfer of Funds from Other Pension Funds TOTAL PENSION BENEFIT LIABILITIES LIABILITIES OUTSIDE PENSION BENEFIT LIABILITIES Pension Benefit and Other Benefits Payable Voluntary Benefit Payable Investment Payable Unearned Revenue Accrued Expenses Other Payables TOTAL LIABILITIES OUTSIDE PENSION BENEFIT LIABILITIES TOTAL LIABILITIES DEFINED CONTRIBUTION PENSION PROGRAM BALANCE SHEET As of DD-MM-YYYY Description Accumulation as of DD-MM-YYYY

Defined Contribution Pension Program Other Benefits Combined INVESTMENT INCOME Interest/Share of Profit Dividends Rent Profit (Loss) from Investment Disposal Other Investment Income Total Investment Income INVESTMENT EXPENSES Transaction Expenses Maintenance Expenses for Land and Buildings Depreciation Expenses for Buildings Investment Manager Expenses Custodian Expenses Other Investment Expenses Total Investment Expenses INVESTMENT RESULTS OPERATIONAL EXPENSES Fee to Founder Total Operational Expenses OTHER INCOME AND EXPENSES Other Income Outside Investment Other Expenses Outside Investment and Operational Total Other Income and Expenses INCOME BEFORE TAX INCOME TAX INCOME AFTER TAX DEFINED CONTRIBUTION PENSION PROGRAM STATEMENT OF COMPREHENSIVE INCOME As of DD-MM-YYYY Description Accumulation as of DD-MM-YYYY

Defined Contribution Pension Program Other Benefits Combined CASH FLOWS FROM INVESTMENT ACTIVITIES Interest/Share of Profit Receipts Dividend Receipts Rent Receipts Other Investment Income Investment Disposal Investment Placement Payment of Investment Expenses Net Cash from Investment Activities CASH FLOWS FROM OPERATIONAL ACTIVITIES Payment of Operational Expenses Income Outside Investment Other Expenses Outside Investment and Operational Income Tax Net Cash from Operational Activities CASH FLOWS FROM FINANCING ACTIVITIES Contribution Receipts Receipts from Transfer of Funds from Other Pension Funds Payments for Transfer of Funds to Other Pension Funds Payment of Pension Benefits and Other Benefits Contribution Withdrawals Net Cash from Financing Activities INCREASE (DECREASE) IN NET CASH CASH AT BEGINNING OF PERIOD CASH AT END OF PERIOD DEFINED CONTRIBUTION PENSION PROGRAM CASH FLOW STATEMENT As of DD-MM-YYYY Description Accumulation as of DD-MM-YYYY

(1) Active Participants a. Individual b. Group (2) Passive Participants (Those Entitled to Pension Benefits) a. Individual b. Group (3) Total DPLK Participants (1) + (2) PENSION FUND PARTICIPATION As of DD-MM-YYYY Description Defined Contribution Pension Program Other Benefits Total

Bank Savings
On-call Deposits at Banks
Term Deposits at Banks
Bank Deposit Certificates
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 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 INVESTMENT Dec DEFINED CONTRIBUTION PENSION PROGRAM Sep Oct INVESTMENT RECAP As of DD-MM-YYYY May Jun Jul Aug Uraian Jan Feb Mar Apr Nov

Bank Savings Term Deposits Deposit Certificates SBI SBN ab cd efg Life Cycle Fund As of DD-MM-YYYY Total Participants Total Funds Investment Assets

Interest/Share of Profit Dividends Rent Profit/Loss Disposal Others Bank Savings On-call Deposits at Banks Term Deposits at Banks Bank Deposit Certificates Securities issued by Bank Indonesia Government Securities Stocks listed on the Indonesia Stock Exchange Corporate Bonds listed on the Indonesia Stock Exchange Sukuk 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 DEFINED CONTRIBUTION PENSION PROGRAM INVESTMENT RESULT REPORT As of DD-MM-YYYY Type of Investment Realized Investment Results Unrealized Investment Results Investment Expenses Net Investment Results Average Investment ROI

Interest/Share of Profit Dividends Rent Profit/Loss Disposal Others Bank Savings On-call Deposits at Banks Term Deposits at Banks Bank Deposit Certificates Securities issued by Bank Indonesia Government Securities Stocks listed on the Indonesia Stock Exchange Corporate Bonds listed on the Indonesia Stock Exchange Sukuk 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 DEFINED CONTRIBUTION PENSION PROGRAM OTHER BENEFITS INVESTMENT RESULT REPORT As of DD-MM-YYYY Type of Investment 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 Term Deposits at Banks Bank Deposit Certificates 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 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 Investment B. Current Assets Outside Investment Cash and Bank Prepaid Expenses Investment Receivables Investment Income Receivables Other Receivables Total Current Assets Outside Investment
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 Outside Pension Benefit Liabilities Pension Benefit and Other Benefits Payable Voluntary Benefit Payable Investment Payable Unearned Revenue Accrued Expenses Other Payables Total Liabilities outside 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 Quantity Percentage Against Total Investment ab c d e f g … Details of Investment with One Counterparty No. Counterparty Name Investment Limit in Investment Instructions Investment Limit According to Regulations

Investment Income Ratio (ROI)
A. Investment income after deducting operational investment expenses B. Average Investment
C. Ratio (a:b)
Investment Income Ratio against Assets (ROA) A. Investment income + other income - investment and non-investment expenses B. Total Available Assets
C. Ratio (a:b)
Operational Expense Ratio (BOPO)
A. Operational Expenses
B. Total Available Assets
C. Ratio (a:b)
FINANCIAL RATIOS
Description Total
Other Benefits
Defined Contribution Pension Program

Package A Package B Package C Package D etc.
Assets
Net Assets
Investments a. Bank Savings b. On-call Deposits at Banks
c. Term Deposits at Banks
d. Bank Deposit Certificates 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 Fund in the form of Collective Investment Contracts o. Infrastructure Investment Fund in the form of Collective Investment Contracts p. Options contracts and forward 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 Outside Pension Benefit Obligations a. Pension Benefit and Other Benefits Payable b. Voluntary Benefit Payable
c. Investment Payable
d. Unearned Revenue e. Accrued Expenses 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 FUND PERIODIC PENSION BENEFIT INVESTMENT REPORT Bank Name/Series Number Government Securities (SBN) Term Deposits Government Securities (SBN) Total Total Participants Periodic Benefits Lump Sum Benefits Initial Reserve (20%) Notes

No.
Investment Manager Name
Contract Number
Contract Date
Contract Period
Type of Investment
Amount of Funds Managed
(Rp)
Net Investment Return Rate
(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 Investment Manager Disclosure Format Pension Fund Use of Investment Manager As of DD-MM-YYYY Total etc.

ab c d e f g
…
Total
SAVINGS DETAILS
No.
Bank Name
Acquisition Date
Nominal Value
Interest Rate/Nisbah
Notes
Pension Program/
Other Benefits

ab c d e f g h
…
Total
ON-CALL DEPOSIT DETAILS
No.
Bank Name
Acquisition Date
Nominal Value
Term
Interest Rate/Nisbah
Notes
Pension Program/
Other Benefits

ab c d e f g h
…
Total
TERM DEPOSIT DETAILS
No.
Bank Name
Acquisition Date
Nominal Value
Term
Interest Rate/Nisbah
Notes
Pension Program/
Other Benefits

ab c d e f g h i j
…
Total
DEPOSIT CERTIFICATE DETAILS
No.
Bank Name
Acquisition Date
Nominal Value
Acquisition Value
Redemption Value
Term
Interest Rate/Nisbah
Notes
Pension Program/
Other Benefits

Value % ab c d e f g h i j k l
…
Total
Notes
INDONESIAN SECURITIES DETAILS
No.
Security Code
Acquisition Date
Nominal Value
Maturity Date
Acquisition Value
Fair Value
Investment Valuation Difference
Coupon (%)
Pension Program/ Other Benefits

Value % ab c d e f g h i j k l m
…
Total
Notes
GOVERNMENT SECURITIES DETAILS
No.
Security Code
Acquisition Date
Nominal Value
Maturity Date
Acquisition Value
Fair Value
Investment Valuation Difference
Coupon (%)
Pension Program/ Other Benefits
Accounting Method

Value % ab c d e f g h i j k l
…
Total
Notes
STOCK DETAILS
No.
Stock Code
Issuer/Issuer Name
Acquisition Date
Number of Shares
Acquisition Value
Market Value
Investment Valuation Difference
Economic Sector
Pension Program/
Other Benefits

Beginning End Value % ab c d e f g h i j k l m n o p q r … Total Accounting Method Pension Program/ Other Benefits Coupon (%) Notes BOND DETAILS No. Issuer Name Bond Code Bond Name Acquisition Date Nominal Value Maturity Date Rating Acquisition Value Fair Value Investment Valuation Difference Economic Sector

Beginning End Value % ab c d e f g h i j k l m n o p q r … Total Notes Pension Program/ Other Benefits Coupon (%) CORPORATE SUKUK DETAILS No. Issuer Name Sukuk Code Sukuk Name Acquisition Date Nominal Value Maturity Date Rating Accounting Method Acquisition Value Fair Value Investment Valuation Difference Economic Sector

Beginning End Value % ab c d e f g h i j k l m n o p q r … Total Coupon (%) 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 Maturity Date Rating Acquisition Value Fair Value Investment Valuation Difference Economic Sector Notes

Value % ab c d e f g h i j k l m
…
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/Corporate Action Collective Investment Contract Limited Participation Mutual Fund/ and Mutual Funds whose Shares/Units are Traded on the Stock Exchange Investment Valuation Difference Notes MUTUAL FUND DETAILS No. Code Product Name Type of Mutual Fund *) Investment Manager Acquisition Date Number of Units Acquisition Value Fair Value Pension Program/ Other Benefits

Economic Sector
Beginning Ending Value % ab c d e f g h i j k l m n o p q … Total DETAILS OF MTN No Code Product Name Issuer Date of Acquisition Nominal Value Maturity Date Rating Acquisition Value Fair Value Investment Valuation Difference Remarks Coupon (%) Pension Program/ Other Benefits

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

Value % ab c d e f g h i j k l
…
Total
Remarks
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 Pension Program/ Other Benefits

Value % ab c d e f g h i j k l
…
Total
Remarks
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 Pension Program/ Other Benefits

Value % ab c d e f g h i j k
…
Total
DETAILS OF OPTIONS CONTRACTS AND FUTURES CONTRACTS OF SECURITIES LISTED ON THE INDONESIA STOCK EXCHANGE No Issuer Name Buyer Name Date of Acquisition Duration Acquisition Value Fair Value Investment Valuation Difference Remarks Pension Program/ Other Benefits

Beginning Ending Nominal % Value % ab c d e f g h i j k l m n op q r … Total Pension Program/ Other Benefits Remarks DETAILS OF REPO No Counterparty Type of Collateral (SBN/SBI/OBL) Date of Acquisition Collateral Value Rating Duration Category (KSEI/BIS4) Acquisition Value Margin Amortized Cost Sale Value Investment Valuation Difference

Economic Sector
Name Position Date % Total Ownership Total % Total Ownership Total Date % Total Ownership Total Value % ab c d e f g h i j k l m n o p q r s … Total *) letter e :
Filled with Domestic Publicly Listed Company/Non-Domestic Publicly Listed Company/Foreign Publicly Listed Company/Non-Foreign Publicly Listed Company Remarks DETAILS OF DIRECT PARTICIPATION No Company Name Pension Fund Representative Category Participation *) Date of Acquisition Initial Placement Acquisition Value As of Report Date Appraisal/Fair Value Investment Valuation Difference Pension Program/ Other Benefits

Type of Object
(Land/Building/Land&Building) Value % a b cde f gh i j k lm n opq r s … Total Investment Valuation Difference Pension Program/ Other Benefits Remarks DETAILS OF LAND, BUILDINGS, LAND AND BUILDINGS IN INDONESIA No Address Location (City,Province) Area Type Proof of Ownership Ownership Document Number Date of Acquisition Acquisition Value Accumulated Depreciation Appraisal Year Appraiser Name Public/Independent Appraiser Book Value Appraisal/ Fair Value

No Cash/Bank Name Account Number Nominal Pension Program/ Other Benefits Remarks (Purpose of use) ab c d e f … Total DETAILS OF CASH AND BANK

No Type of Expense Amount Pension Program/ Other Benefits Remarks ab c d e … Total DETAILS OF PREPAID EXPENSES

No Type of Investment Receivable Date of Acquisition Nominal Pension Program/ Other Benefits Remarks ab c d e f … Total DETAILS OF INVESTMENT RECEIVABLES

No
Type of Investment Income Receivable Nominal Pension Program/ Other Benefits Remarks ab c d e … Total DETAILS OF INVESTMENT INCOME RECEIVABLES

No
Type of Other Receivable Nominal Pension Program/ Other Benefits Remarks ab c d e … Total DETAILS OF OTHER RECEIVABLES

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

<= 1 year >1 year Total ab c d e
…
Total
DETAILS OF DUE VOLUNTARY PENSION BENEFIT DEBTS

No Type of Investment Value Pension Program/ Other Benefits Remarks ab c d e … Total DETAILS OF INVESTMENT DEBTS

No
Details of Income
Received in Advance Party Value Pension Program/ Other Benefits Remarks ab c d e f … Total DETAILS OF ADVANCED INCOME

No
Details of Expenses
Still to be Paid Party Value Pension Program/ Other Benefits Remarks ab c d e f … Total DETAILS OF ACCRUED EXPENSES

No Type of Other Debt Party Value Pension Program/ Other Benefits Remarks ab c d e f … Total DETAILS OF OTHER DEBTS

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

Normal Participant Contribution Normal Employer Contribution ab c d e f g ... Total Details of Contributions Remarks No. Name of Group/ Individual PhDP Contribution Received Pension Program/ Other Benefits

No.
Type of Income Outside
Investment
Amount Pension Program/ Other Benefits Remarks ab c d e ... Total Details of Income Outside Investment

No.
Name of Pension Fund
Transferring Amount Pension Program/ Other Benefits Details of Other Benefits *) Remarks ac d 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. Type of Expense Amount Pension Program/ Other Benefits Remarks ab c d e ... Total Details of Investment Expenses

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

No.
Type of Income Tax
Amount Pension Program/ Other Benefits Remarks ab c d e Total Details of Income Tax

No.
Name of Pension Fund
Transferred Amount Pension Program/ Other Benefits Details of Other Benefits *) Remarks ab 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
FORMAT AND STRUCTURE OF ANNUAL REPORTS FOR TECHNICAL REPORTS OF PENSION FUNDS OF FINANCIAL SERVICE INSTITUTIONS
I. Pension Fund Profile
A. General Profile
Pension Fund Name :
General Register Book Number (NBDU) :
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. Founder
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 :
C. Organization

Management
a. Is there a change in the Acting Board of Trustees or extension of the term of office of the Acting Board of Trustees during the activity period? If Yes, has this been reported to OJK? b. Does the Acting Board of Trustees have a basic knowledge certificate in the field of Pension Funds?
c. Does the Acting Board of Trustees
who already has a basic knowledge certificate in the field of Pension Funds meet the minimum continuing education points?

d. Is there a change in the Supervisory Board or extension of the term of office of the Supervisory Board during the activity period? If Yes, has this been reported to OJK?
2. Number of Pension Fund Employees
Based on Education Level
Elementary School (SD) :
Junior High School (SMP) :
Senior High School (SMU) :
Diploma :
Bachelor's Degree (S1) :
Master's Degree (S2) :
Doctorate (S3) :
Total :
3. Third-Party Service Providers:
a. Does the Pension Fund use third-party services for managing membership administration? If Yes, Fill in the name of the Membership Administration Manager:
b. Does the Pension Fund use third-party services for depositing ownership documents of assets If YES, fill in the name of the depository recipient used
c. Does the Pension Fund
use Investment Manager services?
If YES, fill in the list of names of Investment Managers used (sorted by asset share managed) d. Does the Pension Fund use Appraiser services?

If YES, fill in the list of Appraiser information used:
4. Contributions
a. Does the Employer pay contributions in the correct amount? b. Does the Employer pay contributions on time?
5. Investment
a. Are investment activities during the reporting period in accordance with regulatory provisions? b. Has information regarding investment been communicated to participants?
6. Governance
a. Does the Pension Fund have
Pension Fund Governance Guidelines? b. Has the Pension Fund implemented Pension Fund Governance? D. Pension Fund Membership

Number of Active Pension Fund Employee Participants at the end of the activity period:
Founder (persons) :
Founder Partner (persons) :
Total (persons) :
Total number of participants entitled to
delayed pension at the end of the activity period :
Active Participant Age Structure and
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 up to 20 :
20 to 30 :
30 to 40 :
40 to 50 :
above 50 :
Estimated number of participants entering normal retirement age in one next activity period :
Total number of employers who
include their employees in the
Pension Fund Institution (DPLK) at the end of the activity period :

E. Pensioners and Entitled Parties Description Number < Rp. 750,000.00 Rp. 750,000.00 < Rp. 2,000,000.00 Rp. 2,000,000.00

Rp.
5,000,000.00

Rp.
5,000,000.00

Number of Benefit Recipients

a. Number of
Benefit Recipients
Monthly Pension at the end of the activity period (including those who chose maximum first payment 20%)

i. Pensioners
ii. Widows/Widowers
iii. Children
b. Number of
Benefit Recipients
Pension who receive lump sum payments during the activity period due to:
i. Monthly pension
benefit below ministerial regulation threshold
ii. Reasons other than
item b (i)
c. Number of
Benefit Recipients
Pension purchased annuities during the period
2. Distribution of the number of
pension benefit recipients based on category of pension benefit amount received monthly at

the end of the activity period
i. Pensioners
(persons)
ii. Widows/Widowers
iii. Children
Board of Trustees Statement
We, the Board of Trustees of the Pension Fund, declare that all data and information we submit in this technical report are true data and in accordance with the actual conditions of the Pension Fund. If it is later found that there is data/information that does not correspond to the actual conditions, we are willing to be accountable in accordance with regulatory provisions. Place, Date (date/month/year) (signature) Full Name Position

II. Pension Fund Risk Level Assessment Report
Pension Fund Name :
Type : (1) DPPK PPMP (2) DPPK PPIP (3) DPLK Assessment Date :
Report Date :
A. General Information
Founders and Founder Partners :
Name Remarks Number of Participants Board of Trustees :
Name Position Term of Office
Supervisory Board :
Name Position/Representative Term of Office Financial Information As of Assessment Date Description Value (Rupiah) Ratio per Net Assets Net Assets Investments Normal Contribution Receivables Additional Contribution Receivables Other Receivables Other Assets Operating Income* Funding Ratio (PPMP) Solvency Ratio (PPMP) Return on Investment (ROI)* Number of Participants *For the last one-year period since the assessment date B. Risk Level Assessment Summary Risk Type Risk Value Net Risk Weight

Management
Governance
Strategy
3.1 Inherent Risk
3.2 Management and Control
Operational
4.1 Inherent Risk

4.2 Management and Control
5. Assets and Liabilities
5.1 Inherent Risk
5.2 Management and Control
Total Net Risk Value

Funding Capability
Additional Funding
Total Support Fund Risk Value
Total Net Risk Value
Total Support Fund Risk Value
Risk Value
Risk Level
C. Risk Description
General Description
Description per Risk Type
Management Risk Risk Value:.... Risk Level: ...
Remarks:
Governance Risk Risk Value:.... Risk Level: ...
Remarks:
Strategy Risk Risk Value:.... Risk Level: ...
Inherent Risk Value:
Remarks:
Management and Control Value:
Remarks:
Operational Risk Risk Value:.... Risk Level: ...
Inherent Risk Value:
Remarks:
Management and Control Value:

Remarks:
Asset and Liability Risk Risk Value:.... Risk Level: ... Inherent Risk Value:
Remarks:
Management and Control Value:
Remarks:
Support Fund Risk Risk Value:.... Risk Level: ...
Funding Capability Value:
Remarks:
Additional Funding Value:
Remarks:
Acknowledged,
Name:
Position:
Prepared by:
Name:
Position:

III. Follow-up Plan for Pension Fund Risk Level Assessment

Name :
Type :
(1) DPPK PPMP
(2) DPPK PPIP
(3) DPLK
Risk Level Assessment Date :
Report Date :
Risk Level: 6. Risk Value :
Risk Type 8. Risk Cause 9. Follow-up
Plan
Target Time 11. PIC
Prepared by
Name
:
Signature
Position
:
Acknowledged
Name
:
Signature
Position
:
Filling Guidelines:
Fill in the Pension Fund name.
Fill in the Pension Fund type by selecting one from the list provided.
Fill in the risk level assessment date that serves as the basis for the follow-up plan.
Fill in the date of the signed risk level assessment report.
Fill in the Pension Fund risk level according to the risk level assessment results
as referred to in item 3.
Fill in the Pension Fund risk value according to the risk level assessment results as referred
to in item 3.
Fill in the risk type as referred to in POJK number 10/POJK.05/2014
concerning Risk Level Assessment of Non-Bank Financial Service Institutions.
Fill in the risk cause.
Fill in the plan for various follow-up steps to be taken to
reduce the risk level for each risk area.
Fill in the target time for implementing follow-up actions to be taken for each
follow-up step, which can be the completion date of the follow-up or the start and end dates of the follow-up if the target time for starting the follow-up is not immediately after the follow-up plan is drawn up.
Fill in the unit responsible for implementing the follow-up.
Fill in the name of the official preparing the follow-up plan for the Pension Fund risk level assessment.
Fill in the signature of the official preparing the follow-up plan for the Pension Fund risk level assessment.
Fill in the job title of the official preparing the follow-up plan for the Pension Fund risk level assessment.
Fill in the name of the Pension Fund official handling Pension Fund risk management.
Fill in the signature of the Pension Fund official handling Pension Fund risk management.
Fill in the job title of the Pension Fund official handling Pension Fund risk management.

IV. Self-Assessment Report on the Implementation of Risk Management
SELF-ASSESSMENT REPORT
ON THE IMPLEMENTATION OF RISK MANAGEMENT PENSION FUND YEAR … PENSION FUND XYZ (Pension Fund Address)

SELF-ASSESSMENT REPORT
ON THE IMPLEMENTATION OF PENSION FUND RISK MANAGEMENT Pension Fund Name :
Pension Fund Type : (1) DPPK PPMP (2) DPPK PPIP (3) DPLK Assessment Date :
Report Position Date :
A. GENERAL INFORMATION
Founders and Founder Partners:
No. Name Remarks Number of Participants 1.
2. et c.
Board of Trustees:
No. Name Position Term of Office
1.
2.
3. et c.
Supervisory Board:
No. Name Position Term of Office
1.
2.
3. et c.

B. PENSION FUND FINANCIAL INFORMATION Description Value (Rupiah) Ratio per Net Assets Net Assets Investments Normal Contribution Receivables Additional Contribution Receivables Other Receivables Other Assets Operating Income* Funding Ratio (PPMP) Solvency Ratio (PPMP) Return on Investment (ROI)* Number of Participants

For the last one-year period since the assessment date
C. SUMMARY OF RISK MANAGEMENT IMPLEMENTATION IN GENERAL

Active Supervision by Directors and Board of Commissioners
…………… (Filled with a description of the role of the Board of Directors and Board of Commissioners in Risk Management and the structure of the Risk Management organization)
Adequacy of Policies, Procedures, and Risk Limit Setting
…………… (Filled with a description of risk appetite, risk tolerance, and risk limit setting)
Adequacy of the Risk Identification, Measurement, Monitoring, and
Control Process
…………… (Filled with a description of the identification, measurement, monitoring, and control process of Risk)
Risk Management Information System
…………… (Filled with a description of how the pension fund's information system supports the implementation of Risk Management)
Comprehensive Internal Control System
…………… (Filled with a description of how internal control including the compliance function is carried out by the pension fund)

D. IMPLEMENTATION OF RISK MANAGEMENT FOR EACH TYPE OF RISK

Strategy Risk
Scope of Implementation
Risk Management Description
Active Supervision by Directors and Board of Commissioners …………… (Filled with a description of active supervision by the Board of Directors and Board of Commissioners over Strategy Risk) Adequacy of Policies, Procedures, and Risk Limit Setting …………… (Filled with a description of risk appetite, risk tolerance, and limit setting over Strategy Risk) Adequacy of Process Identification, Measurement, Monitoring, and Risk Control …………… (Filled with a description of the process of identification, measurement, monitoring, and control over Strategy Risk) Risk Management Information System Strategy …………… (Filled with a description of how the pension fund's information system supports the implementation of Risk Management over Strategy Risk) Comprehensive Internal Control System …………… (Filled with a description of how internal control including the compliance function is carried out by the pension fund for Strategy Risk)
Operational Risk
Scope of Implementation
Risk Management Description
Active Supervision by Directors and Board of Commissioners …………… (Filled with a description of active supervision by the Board of Directors and Board of Commissioners over Operational Risk) Adequacy of Policies, Procedures, and Risk Limit Setting …………… (Filled with a description of risk appetite, risk tolerance, and limit setting over Operational Risk) Adequacy of Process Identification, Measurement, Monitoring, and Risk Control …………… (Filled with a description of the process of identification, measurement, monitoring, and control over Operational Risk) Risk Management Information System Operational …………… (Filled with a description of how the pension fund's information system supports the implementation of Risk Management over Operational Risk) Comprehensive Internal Control System …………… (Filled with a description of how internal control including the compliance function is carried out by the pension fund for Operational Risk)
Asset and Liability Risk
Scope of Implementation
Risk Management Description
Active Supervision by Directors and Board of Commissioners …………… (Filled with a description of active supervision by the Board of Directors and Board of Commissioners over Asset and Liability Risk) Adequacy of Policies, Procedures, and Risk Limit Setting …………… (Filled with a description of risk appetite, risk tolerance, and limit setting over Asset and Liability Risk) Adequacy of Process Identification, Measurement, Monitoring, and Risk Control …………… (Filled with a description of the process of identification, measurement, monitoring, and control over Asset and Liability Risk) Risk Management Information System …………… (Filled with a description of how the pension fund's information system supports the implementation of Risk Management over Asset and Liability Risk) Comprehensive Internal Control System …………… (Filled with a description of how internal control including the compliance function is carried out by the pension fund for Asset and Liability Risk)
Management Risk
Scope of Implementation
Risk Management Description
Active Supervision by Directors and Board of Commissioners …………… (Filled with a description of active supervision by the Board of Directors and Board of Commissioners over Management Risk) Adequacy of Policies, Procedures, and Risk Limit Setting …………… (Filled with a description of risk appetite, risk tolerance, and limit setting over Management Risk) Adequacy of Process Identification, Measurement, Monitoring, and Risk Control …………… (Filled with a description of the process of identification, measurement, monitoring, and control over Management Risk) Risk Management Information System …………… (Filled with a description of how the pension fund's information system supports the implementation of Risk Management over Management Risk)

Comprehensive Internal
Control System
…………… (Filled with a description of how internal control including the compliance function is carried out by the pension fund for Management Risk)
5. Governance Risk
Scope of Implementation
Risk Management Description
Active Supervision by Directors and Board of Commissioners …………… (Filled with a description of active supervision by the Board of Directors and Board of Commissioners over Governance Risk) Adequacy of Policies, Procedures, and Risk Limit Setting …………… (Filled with a description of risk appetite, risk tolerance, and limit setting over Governance Risk) Adequacy of Process Identification, Measurement, Monitoring, and Risk Control …………… (Filled with a description of the process of identification, measurement, monitoring, and control over Governance Risk) Risk Management Information System …………… (Filled with a description of how the pension fund's information system supports the implementation of Risk Management over Governance Risk) Comprehensive Internal Control System …………… (Filled with a description of how internal control including the compliance function is carried out by the pension fund for Governance Risk)
6. Support Fund Risk
Scope of Implementation
Risk Management Description
Active Supervision by Directors and Board of Commissioners …………… (Filled with a description of active supervision by the Board of Directors and Board of Commissioners over Support Fund Risk) Adequacy of Policies, Procedures, and Risk Limit Setting …………… (Filled with a description of risk appetite, risk tolerance, and limit setting over Support Fund Risk)

Adequacy of Process
Identification,
Measurement,
Monitoring, and
Risk Control
…………… (Filled with a description of the process of identification, measurement, monitoring, and control over Support Fund Risk) Risk Management Information System …………… (Filled with a description of how the pension fund's information system supports the implementation of Risk Management over Support Fund Risk) Comprehensive Internal Control System …………… (Filled with a description of how internal control including the compliance function is carried out by the pension fund for Support Fund Risk) Prepared by, Acknowledged, (Signature) (Signature) (Name) (Name) (Position) (Position)

V. Pension Fund Governance Implementation Report

Transparency of Good Governance Implementation for Pension Funds
a. Acting Board of Trustees

Number, job title, criteria, appointment date, term of office,
citizenship, and domicile of Acting Board of Trustees members No Name Position Criteria Appointment Date Term of Office Citizenship Domicile Last Formal Education And Professional Degree Competency And Fit and Proper Test 1. 2. et c.
Concurrent positions of Acting Board of Trustees
No. Name
Position at Pension
Fund
Position at Other Pension Fund
Position at Other Companies and/or institutions 1.

et c.
et c.
et c.

Frequency of Acting Board of Trustees meetings held in 1
(one) month.
No Name Position
Number of Acting Board of Trustees Meetings (... meeting times) % Attendance Physical Attendance Teleconference/Video/ Conference/Other Electronic Media Facilities 1. 2. et c.
Family relationships between members of the Working Board of Directors and other members of the Working Board of Directors, and/or members of the Supervisory Board of the Pension Fund where the aforementioned Working Board of Directors members serve.

No. Name
Family Relationship with Other Working Board of Directors Members Supervisory Board of Pension Fund Yes No N/A*) Yes No N/A*) 1. 2. Etc.

Note:
*) Form of family relationship: spouse/child/parent/sibling/in-law, etc.

b. Supervisory Board

Number, job titles, criteria, appointment dates, tenure, nationality, and domicile of Supervisory Board members.

No. Name
Job Title
Criteria
Appointment Date
Tenure
Nationality
Domicile
Last Formal Education and Professional Title Fit and Proper Test 1. 2. Etc.

Concurrent positions of the Supervisory Board

No. Name
Position in Pension Fund
Position in Other Pension Fund
Position in Other Companies and/or Institutions 1.
1.
2.
Etc.
2. 1.
2.
Etc.
Etc.

Frequency of Supervisory Board meetings held within 1 (one) month.

No. Name
Job Title
Number of Supervisory Board Meetings (... times meetings) % Attendance Physical Attendance Teleconference/Video/Conference/Electronic Media Facilities 1.

Etc.

Family relationships between Supervisory Board members and other Supervisory Board members, Working Board of Directors members, and/or Working Board of Directors members where the aforementioned Supervisory Board members serve.

No. Name
Family Relationship with Other Supervisory Board Members Working Board of Directors Members Working Board of Directors Members Yes No N/A*) Yes No N/A*) Yes No N/A*) 1. 2. Etc.

Note:
*) Form of family relationship: spouse/child/parent/sibling/in-law, etc.

c. Supervisory Board Supervision Results Report

Supervisory Board activity reports on the application of Pension Fund Corporate Governance
Summary of Supervision Results Recommendations

d. Committees

Functions under the Working Board of Directors

No.
Name
Function
Member Name
Job Title
Tenure
Appointment Decree
Number of Meetings in One Year
1.
Internal Auditor Function
1.
2.
Etc.
2.
Risk Management Function
1.
2.
Etc.
3. Compliance Function
1.
2.
Etc.
Etc.

Committees under the Supervisory Board

No.
Committee Name
Member Name
Job Title
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. Application of external auditor functions.

No. Description
Year n-2
Year n-1
Year n

Name of Public Accounting Firm
Name of Public Accountant
Audit Period
Appointment by Supervisory Board

f. Application of remuneration and other facility policies for Working Board of Directors members, Supervisory Board members, and Employees. The number of Working Board of Directors members, Supervisory Board members, and Employees receiving remuneration packages within 1 (one) year, grouped by income level as follows:

Individual Remuneration Amount within 1 year *) Number of Working Board of Directors Members Number of Supervisory Board Members Employees Above Rp 2 billion Above Rp 1 billion to Rp 2 billion Above Rp 500 million to Rp 1 billion Rp 500 million and below

Note: *) requested in cash

g. Outsourcing of Investment Management

No. Type of Investment
Name of Outsourcing Company
Investment Value
Agreement No.
% of Total Investment Portfolio
1.
2.
Etc.

h. Disclosure of other important matters. Disclosure of other important matters

No. Description
Checklist *) If Yes, Yes No Explain 1.
Resignation or dismissal of external auditor
2. Material transactions with related parties
4.
Ongoing and/or potential Conflicts of Interest
5. Other material information regarding the Pension Fund
6. The Pension Fund has a compliance function
7. The Pension Fund has an internal auditor
8. The Pension Fund has a risk management function
9.
The Pension Fund has an investment management function/unit 10. The Pension Fund has a special work unit and/or appoints a PJK official responsible for the application of AML and CFT programs *) select one answer by marking a “√”

) Related Parties are individuals or companies/entities that have a controlling relationship with the Pension Fund, directly or indirectly, through ownership, management, and/or financial relationships.

Self-Assessment on the Application of Good Pension Fund Corporate Governance
The completion of the questionnaire on the Application of Good Pension Fund Corporate Governance is conducted by the respective Pension Fund. This questionnaire is completed by providing answers to the questions/statements in the questionnaire.

Completion Method:
Generally, answers to the Questions/Statements consist of 5 criteria as follows (except for answers requiring different criteria):
A= The respective Pension Fund DOES NOT HAVE a written policy regarding the Question/Statement in question. B= The respective Pension Fund HAS a written policy regarding the Question/Statement in question, but the policy has NOT been implemented. C= The respective Pension Fund HAS a written policy regarding the Question/Statement in question, but the policy has NOT been implemented CONSISTENTLY. D= The respective Pension Fund HAS a written policy regarding the Question/Statement in question, the policy is IMPLEMENTED CONSISTENTLY but has NOT BEEN UPDATED periodically. E= The respective Pension Fund HAS a written policy regarding the Question/Statement in question and the policy is IMPLEMENTED CONSISTENTLY and UPDATED periodically.

Interpretation of Results
An assessment is required to interpret the score obtained in answering the questions in this Questionnaire, the majority of which consist of 5 (five) scales from the lowest assessment (A/No) to the highest assessment (E/Yes). Specifically, for answers of "A/No" on assessment criteria required by statutory regulations (mandatory), a negative score is given. For groups of Questions/Statements skipped due to "None" and which are not "not applicable," the result interpretation must still be calculated by giving the same score as the answer "A/No."

I. 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 statutory regulations and 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 beneficiaries
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. 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, Working Board of Directors members, Supervisory Board members, and pension fund employees:
5.1. Make a statement of "no conflict of interest" regarding every decision made by the authorized decision-makers
No Yes
5.2. Make an annual statement regarding the implementation of the Code of Conduct established by the Pension Fund
No Yes
5.3. Make an annual statement not to receive or give anything that could influence decision-making
No Yes
The Pension Fund records assets, liabilities, and own equity correctly using generally accepted accounting principles or special accounting principles for pension funds
No Yes
Has a complaint system regarding violations of the Code of Conduct, Pension Fund regulations, and statutory regulations, and matters related to Participants, which ensures protection for whistleblowers.
A B C D E

II. PENSION FUND ORGANS
A. Founders and Co-Founders

Founders and Co-Founders 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 GCG. A B C D E
1.4. Following up on audit findings and recommendations from units performing internal auditor functions, external auditor functions, and/or supervision results of the Financial Services Authority (OJK)
A B C D E
B. Working Board of Directors
Composition, Appointment, and Dismissal of Working Board of Directors
1.1. The DPLK Founder acts as the Board of Directors, and in management, the DPLK Founder must appoint Working Board of Directors members.
No Yes
1.2. The number of Working Board of Directors members has been adjusted to the complexity of the company while still considering the effectiveness of decision-making.
No Yes
1.3. Working Board of Directors members consist of members who collectively possess competence*) such as:
1.3.a Investment Field No Yes
1.3.b Risk Management Field. No Yes
Requirements for Working Board of Directors Members
2.1. Working Board of Directors members meet the articles of association requirements
No Yes
2.2. Working Board of Directors members meet the fit and proper requirements according to the regulations of the supervisory authority
No Yes
2.3. Working Board of Directors members must understand and implement GCG
A B C D E
2.4. Working Board of Directors members are prohibited from utilizing the Pension Fund for the interests of themselves, family, business groups, or other parties to the detriment of the Pension Fund
No Yes
2.5. Do not hold concurrent positions as members of the Supervisory Board or DPS of the same Pension Fund
No Yes

2.6. Do not hold concurrent positions as directors or commissioners or equivalent in other companies and/or institutions
No Yes
2.7. The Board of Directors and Working Board of Directors do not hold concurrent positions as members of the Board of Directors, Working Board of Directors, Supervisory Board, or DPS of other Pension Funds.
No Yes
3. Functions of the Working Board of Directors
3.1. Management
3.1.1. The Working Board of Directors is fully responsible for the management of the Pension Fund
A B C D E
3.1.2. The Working Board of Directors manages available 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. The Working Board of Directors considers the legitimate interests of stakeholders
A B C D E
3.1.4. The Working Board of Directors has and complies with work rules and charters regulated in the DPLK and statutory regulations in the field of Pension Funds
A B C D E
3.1.5. A Board of Directors member overseeing the compliance function cannot be held concurrently by a Board of Directors member overseeing funding, financial, or investment functions, unless the number of Board of Directors members is 2 (two), in which case the compliance function can be held concurrently by a Board of Directors member overseeing financial functions
No Yes
3.2. Risk Management
3.2.1. The Working Board of Directors formulates and implements a Risk Management System covering all aspects of Pension Fund activities
A B C D E
3.2.2. The Pension Fund has a Risk Monitoring Committee and a Risk Management Work 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 duties to the Founder and Co-Founders No Yes

3.4. Information Technology
3.4.1. The company has an integrated computerized administration system
A B C D E
3.4.2. The company has Standard Operating Procedures for the Information Technology department
A B C D E
4. Accountability of the Working Board of Directors
4.1. The Working Board of Directors prepares a report on the management of the Pension Fund in the form of an Annual Report
No Yes
4.2. Annual Report criteria include:
4.2.1. Contains at least:
a. Financial Report No Yes b. Pension Fund Activity Report No Yes
c. GCG Implementation Report No Yes
4.2.2. Approved by the Founder and Co-Founders No Yes
4.2.3. Specifically, the financial report must be approved by the Founder and Co-Founders
No Yes
4.3. Working Board of Directors Meetings
4.3.1. Every strategic policy and decision must be decided through a DPPK Board meeting, considering supervision according to the duties and responsibilities of the Supervisory Board
No Yes
4.3.2. The Working Board of Directors holds meetings regularly at least 1 (one) time in 1 (one) month
No Yes
4.3.3. The Working Board of Directors Board of Directors establishes meeting rules
No Yes
4.3.4. Every Board of Directors and Working Board of Directors meeting creates meeting minutes
No Yes
4.3.5. Meeting minutes include dissenting opinions with decisions taken in the meeting (if any)
A B C D E
4.3.6. Every Working Board of Directors member, whether attending the meeting or not, has the right to receive the Working Board of Directors Meeting Minutes
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 company while still considering the effectiveness of decision-making.
No Yes

1.2. All Supervisory Board members consist of members who collectively possess competence relevant to their positions
No Yes
1.3. Do not hold concurrent positions as Working Board of Directors, or DPS of the same DPLK, or Supervisory Board, Board of Directors, or DPS of other DPLKs
No Yes
2. Competence and Integrity of the Supervisory Board
2.1. Meet the Fit and Proper Test requirements No Yes
2.2. Monitor the effectiveness of the application of Pension Fund GCG governance
A B C D E
2.3. Do not utilize the Pension Fund for the interests of themselves, family, business groups, or other parties, which can harm the Pension Fund.
No Yes
3. Supervisory Board Supervision Functions
3.1. The Supervisory Board supervises the management of the Pension Fund by the Working Board of Directors
A B C D E
3.2. Execute the duties and responsibilities of the Supervisory Board as regulated in the DPLK and statutory regulations in the field of Pension Funds independently
No Yes
3.3. The Supervisory Board holds meetings regularly No Yes
3.4. Every Supervisory Board meeting creates meeting minutes No Yes
3.5. Meeting minutes include dissenting opinions with decisions taken in the meeting
A B C D E
3.6. Every Supervisory Board member, whether attending the meeting or not, has the right to receive the Commissioners' Meeting Minutes
No Yes
4. Supervisory Board Committees (answered if applicable)
4.1. Audit Committee
No
Yes
Continue to
4.1.7.
The Audit Committee acts 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
No Yes
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 No Yes b. Other parties outside the Pension Fund who do not have financial, management, and/or family relationships with the Supervisory Board, DPPK Board, Working Board of Directors, and/or Founder, or other relationships that can influence 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 properly A B C D E b. Internal audit is conducted according to applicable auditing 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 auditing 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 acts 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 Company, including assessing the risk tolerance taken by the Board of Directors.
A B C D E
4.2.3. Risk Monitoring Committee members consist of:
a. Supervisory Board members representing Participants No Yes b. Other parties No Yes
4.2.4. For Companies that do not have a Risk Monitoring Committee, there are Supervisory Board members who specifically serve for the following matters:
a. Assess the quality of risk management policies A B C D E

b. Assess the effectiveness of risk management applied by the company, including assessing the risk tolerance taken by the Board of Directors. A B C D E
4.3. Nomination and Remuneration Committee
No
Yes
Continue to 4.3.4.
The Nomination and Remuneration Committee acts as a facilitator for the Supervisory Board for the following matters:
4.3.1. Facilitator for the Supervisory Board in assisting the Founder in setting criteria and selecting candidates for the Supervisory Board and Board of Directors or Working Board of Directors of the Pension Fund
A B C D E
4.3.2. Facilitator for the Supervisory Board in assisting the Founder to establish a remuneration system
A B C D E
4.3.3. Nomination and Remuneration Committee members 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. Assist the Founder in setting criteria and selecting candidates for the Supervisory Board and Board of Directors or Working Board of Directors of the Pension Fund A B C D E b. Assist the Founder to establish a remuneration system A B C D E

III. HEALTHY BUSINESS PRACTICES
External Auditor

External Auditor (public accounting firm) conducts independent examinations of the truthfulness of the Pension Fund's financial reports
No Yes
The appointed public accounting firm (KAP) is registered with the Financial Services Authority (OJK)
No Yes
Action Plan
No.
Corrective Action
Completion Target
Completion Obstacles
Notes

Etc.

Application of Anti-Fraud Strategy
Name of Company)..............................
FRAUD CONTROL REPORT AND ANTI-FRAUD STRATEGY APPLICATION YEAR …… a. Inventory of Fraud Incidents and Follow-up Type Fraud a) Date of Fraud Occurrence Division/Section Occurrence of Fraud Parties Involved b) Position in Rupiah Loss c) Company Actions d) Weaknesses/Causes of Fraud e) Follow-up/ Improvement f) Chronology of Fraud g) b. Progress of Anti-Fraud Strategy Implementation

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

VI. Evidence of Fulfillment of Qualification Requirements for Working Board of Directors and Investment-Bid Employees
FORM :
FORM SELF ASSESSMENT
SUSTAINABILITY REQUIREMENT FULFILLMENT REPORT WORKING BOARD OF DIRECTORS AND EMPLOYEES INVOLVED IN INVESTMENT Name of Pension Fund :
Report Letter Number :
Report Letter Date :
Contact Person (Name,
Tel/e-mail)
:
NO DESCRIPTION LEGAL BASIS YES NO NOTES 1.
The sustainability requirement fulfillment report is submitted by the Pension Fund Board to the OJK no later than 1 (one) month after the annual period ends. o POJK 3/POJK.05/2015 o POJK 5/POJK.05/2018
2. Evidence of sustainability requirement fulfillment
Additional notes (if necessary):
No. Name
Type of
Principal Party *)
No. and date of FPT Decree
Type of
Fulfillment *)
Title of
Activity
Organizer of
Activity *)
Name of
Organizer
Date of
Execution
Fulfillment
Year
Evidence of
Fulfillment *)
..... o Working
Board of
Directors o Employees
..... o Attending seminars, workshops, or other similar activities o Attending courses, training, or similar educational programs o Writing papers, articles, or other written works published o Acting as speakers in seminars, workshops, or other similar activities, acting as instructors or acting as instructors in courses, training, or similar educational programs ..... o Financial service regulatory bodies within and outside the country o Financial service institution associations within and outside the country o Universities within and outside the country o Training institutions that have licenses from competent authorities ..... ..... ..... o Certifi cate (number and date ) o Attendance proof o Others , namely
.....
Note:

Completion method: click twice in the box, then select "Checked"
*) select one
This Self Assessment Form is prepared based on OJK Regulation No. 3/POJK.05/2015 on Pension Fund Investments
Types of sustainability requirement fulfillment related to knowledge in the field of investment and/or risk management as regulated in OJK Regulation No. 3/POJK.05/2015 on Pension Fund Investments

FORMAT II C
A. Report on Consumer Complaint Services and Resolution by Financial Service Business Actors The form and structure of consumer complaint reports and follow-up services and resolution of consumers as referred to in the Financial Services Authority Regulations regarding Consumer Complaint Services in the Financial Service Sector refer to the form and structure as contained in the Appendix of the Financial Services Authority Circular Letter regarding Services and Resolution of Consumer Complaints by Financial Service Business Actors. B. Report on the Appointment of Public Accountants and/or Public Accounting Firms in the Context of Auditing 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 auditing annual historical financial information as referred to in the Financial Services Authority Regulations regarding the Use of Public Accountants and Public Accounting Firms in Financial Services refer to the form and structure as contained in the Appendix of the Financial Services Authority Circular Letter regarding Procedures for the Use of Public Accountants and Public Accounting Firms in Financial Services.
C. Report on the Audit Committee's Evaluation Results Regarding the Implementation of Audit Services on 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 on annual historical 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 refer to the form and structure as contained in the Appendix of the Financial Services Authority Circular Letter regarding Procedures for the Use of Public Accountants and Public Accounting Firms in Financial Services.

D. Periodic Actuarial Report
A. Actuarial Report for Pension Funds Administering Certain Pension Contribution Programs and Making Periodic Pension Benefit Payments

General Data
Report Number
Reporting Date
Company Code
Company Name
Company Address
Reporting Period
Reporting Month
Fiscal Year
Type of Reporting Period: Annual Report Board of Directors Name Board of Directors Position

Actuarial Statement
1.1 Company Actuarial Information:

Actuary Name;
Office Address and Telephone Number;

I, the undersigned, declare that:

All data received is complete and can be justified for the purpose of preparing the Actuarial Report to the best of the actuary's knowledge, and therefore testing has been conducted to assess its reliability.
The report complies with regulations in the field of Pension Funds.
The report complies with the Employer's requirements.
The report is prepared based on the PDP (Pension Funding Plan); and
The report is prepared based on actuarial practice standards for Pension Funds applicable in Indonesia;

Place, date of preparation
Signature
Name
No. Indonesia Actuarial Association (PAI) Register Public Actuary License No.:
for Periodic Actuarial Reports as referred to in the Financial Services Authority Regulation regarding Pension Fund Funding.

Actuarial Valuation Date
Actuarial valuation date reported
Actuarial valuation date of the previous period
Purpose of Preparation
Summary of PDP including payment patterns and normal retirement age
Summary of the number of Participants, widows/widowers, and children choosing periodic Pension Benefit payments
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
A. Executive Summary

Financial Indicators
No. Description Projection
Million Rupiah % Growth
1 Assets
2 Investments
3 Liabilities
4 Investment Income
5 Investment Costs
6 Investment Business Results
7 Operational Costs
8 Pre-Tax Business Results
9 Post-Tax Business Results
Financial Ratios
No. Description %
1 Investment Income Ratio (ROI)
2 Investment Income to Assets Ratio (ROA) 3 Operational Cost Ratio (BOPO)
Non-Financial Executive Summary
The non-financial executive summary contains a summary of information regarding targets for 1 (one) to 3 (three) years ahead, which the Pension Fund considers very necessary to include in the executive summary.

B. Evaluation of Previous Period Business Plan Implementation Indicator 20XX-1 20XX-2 20XX-3 Plan Realization % Plan Realization % Plan Realization % (1) (2) (1/2) (1) (2) (1/2) (1) (2) (1/2) Investment Income Ratio (ROI) for the Pension Fund business plan as referred to in the Financial Services Authority regulation regarding good governance for Pension Funds

Indicator 20XX-1 20XX-2 20XX-3
Plan Realization % Plan Realization % Plan Realization % (1) (2) (1/2) (1) (2) (1/2) (1) (2) (1/2) Investment Income to Assets Ratio (ROA) Operational Cost Ratio (BOPO) Fund Sufficiency Ratio

C. Vision, Mission, Business Strategy, and Management Policy
Completed with targets to be achieved for 1 (one) to 3 (three) years ahead, accompanied by policies and strategies to be implemented.

Vision and mission
Business Strategy and Management Policy
No. Target Policy Strategy

a. 1)

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

No. Target Policy Strategy
Etc

A. Implementation of Risk Management and Compliance Scope of Risk Management Implementation Description Active Supervision Managers, Acting Managers, and Supervisory Board …………… (Filled with a description of the roles of Managers, Acting Managers, and the Supervisory Board in Risk Management and the Risk Management organizational structure) Adequacy of Policies, Procedures, and Risk Limit Setting …………… (Filled with a description of risk appetite, risk tolerance, and risk limit setting) Adequacy of Risk Identification, Measurement, Monitoring, and Control Processes …………… (Filled with a description of the risk identification, measurement, monitoring, and control processes) Risk Management Information System …………… (Filled with a description of how the pension fund information system supports the implementation of Risk Management) Comprehensive Internal Control System …………… (Filled with a description of how internal control, including the compliance function, is conducted by the pension fund)

B. Implementation of Pension Fund Governance

Pension Fund Governance Implementation Plan
Action Plan
No. Corrective Action Target Completion Obstacle Completion Notes 1. Etc
Anti-Fraud Strategy Implementation Plan

C. Current and Previous Period Pension Fund Financial Performance

Investment Income
No. RKAP Year n-1 RKAP Year n Actual as of September Year n % Achievement % Increase (Decrease) against RKAP Year n-1 1 2 3 4 5=4/3 6=(5-4)/4
Investment Business Results
No. Investment Type Investment Business Results RKAP Year n-1 RKAP Year n Actual as of 30 September Year n % Achievement % Increase (Decrease) against RKAP Year n-1 1 2 3 4 5 6=5/4 7=(4-3)/3
Business Results
No. Profit
RKAP Year n-1 RKAP Year n Actual as of 30 September Year n % Achievement % Increase (Decrease) against RKAP Year n-1 1 2 3 4 5 6=5/4 7=(4-3)/3 Pre-Tax Business Results Post-Tax Business Results

D. Financial Statement Projections and Assumptions Used

Financial Position Projection for Pension Funds
(in millions of rupiah)
DESCRIPTION Actual as of 30 Sept 20XX1* Projection as of 31 Dec 20XX-1* Projection Year 1 Projection as of 31 Mar 20XX* Projection as of 30 Jun 20XX* Projection as of 30 Sep 20XX* Projection as of 31 Dec 20XX* Projection as of 31 Dec 20XX+1* Projection as of 31 Dec 20XX+ ASSETS INVESTMENTS Bank Savings Call Deposits at Banks Time Deposits at Banks Bank Certificates of Deposit Securities issued by Bank Indonesia

DESCRIPTION Actual as of 30 Sept 20XX1* Projection as of 31 Dec 20XX-1* Projection Year 1 Projection as of 31 Mar 20XX* Projection as of 30 Jun 20XX* Projection as of 30 Sep 20XX* Projection as of 31 Dec 20XX* Projection as of 31 Dec 20XX+1* Projection as of 31 Dec 20XX+ 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 listed on the Indonesia Stock Exchange

REPO

Direct Participation

Land in Indonesia

Buildings in Indonesia

Land and Buildings in Indonesia

TOTAL INVESTMENTS

INVESTMENT VALUATION DIFFERENCE
CURRENT ASSETS OTHER THAN INVESTMENTS

Cash and Banks

Contribution Receivables

Prepaid Expenses

Investment Receivables

Investment Income Receivables

Other Receivables

TOTAL CURRENT ASSETS OTHER THAN INVESTMENTS

OPERATIONAL ASSETS

Land and Buildings

Vehicles

Computer Equipment

Office Equipment

Other Operational Assets

Accumulated Depreciation

TOTAL ASSETS

LIABILITIES

ACTUARIAL PRESENT VALUE
ACTUARIAL PRESENT VALUE DIFFERENCE LIABILITIES OTHER THAN ACTUARIAL PRESENT VALUE Actuarial Present Value of Pension Benefits and Other Benefits Due

Investment Liabilities

Unearned Income

Expenses Incurred but Not Yet Paid

Other Liabilities
Voluntary Benefit Liabilities

DESCRIPTION Actual as of 30 Sept 20XX1* Projection as of 31 Dec 20XX-1* Projection Year 1 Projection as of 31 Mar 20XX* Projection as of 30 Jun 20XX* Projection as of 30 Sep 20XX* Projection as of 31 Dec 20XX* Projection as of 31 Dec 20XX+1* Projection as of 31 Dec 20XX+ TOTAL LIABILITIES OTHER THAN ACTUARIAL PRESENT VALUE TOTAL LIABILITIES

Notes:
*If the business plan submission is for the years 2015 - 2017, then 20XX-1 is the year 2014 (current year), 20XX is the year 2015, etc. If the description below has no numbers related to SAP, it is entered manually in the ratio:

Income Statement Projection
(in millions of rupiah)
DESCRIPTION Actual Actual Projection Projection Year 1 Jan-Sept 20XX1* Jan-Dec 20XX1* Jan-Mar 20XX* Jan-Jun 20XX* Jan-Sep 20XX* Jan-Dec 20XX* Jan-Dec 20XX+1* Jan-31 Dec 20XX+ INVESTMENT INCOME Interest/Profit Sharing Dividends Rent Profit (Loss) Investment Disposal Other Investment Income - Total Investment Income INVESTMENT COSTS Transaction Costs Maintenance Costs for Land and Buildings

Building Depreciation Costs

DESCRIPTION Actual Actual Projection Projection Year 1 Jan-Sept 20XX1* Jan-Dec 20XX1* Jan-Mar 20XX* Jan-Jun 20XX* Jan-Sep 20XX* Jan-Dec 20XX* Jan-Dec 20XX+1* Jan-31 Dec 20XX+ Investment Manager Costs Custody Costs Other Investment Costs Total Investment Costs INVESTMENT BUSINESS RESULTS

-
OPERATIONAL COSTS

Salaries/Honorary Fees for Employees, Managers, and Supervisory Board Office Costs

-
Maintenance Costs
Depreciation Costs
Third-Party Service Costs
Other Operational Costs
Total Operational Costs
OTHER INCOME AND EXPENSES

Late Contribution Interest
Profit (Loss) from Sale of Operational Assets

-
Profit (Loss) from Sale of Other Assets

Other Income Outside of Investments Other Expenses Outside of Investments and Operations Total Other Income and Expenses PRE-TAX BUSINESS RESULTS

Notes:
*If the business plan submission is for the years 2015 - 2017, then 20XX-1 is the year 2014 (current year), 20XX is the year 2015, etc.

Projection of Ratios and Other Specific Items for Pension Funds
(in millions of rupiah)
(ratios in percentage)
DESCRIPTION Actual Projection Year 1 Jan-Sept 20XX1* Jan-Dec 20XX1* Jan-Mar 20XX* Jan-Jun 20XX* Jan-Sep 20XX* Jan-Dec 20XX* Jan-Dec 20XX+1* Jan-Dec 20XX+2* Investment Income Ratio (ROI) Investment Income to Assets Ratio (ROA) Operational Cost Ratio (BOPO) Funding Ratio Solvency Ratio Fund Sufficiency Ratio ALM Ratio

Notes:
*If the business plan submission is for the years 2015 - 2017, then 20XX-1 is the year 2014 (current year), 20XX is the year 2015, etc. If there are accounts that must be filled from accumulated calculations, e.g., from the income statement, they are filled with accumulated values.

Assumptions Used

E. Pension Fund Plan

Funding Plan
The funding plan generally comes from contributions or development results. Contributions can be made by the employer alone or jointly by the employer and employees (participants). DESCRIPTION Actual Projection Year 1 As of 30 Sept 20XX-1 As of 31 Dec 20XX-1 As of 31 Mar 20XX As of 30 Jun 20XX As of 30 Sep 20XX* As of 31 Dec 20XX As of 31 Dec 20XX+ As of 31 Dec 20XX+ FUNDING Contributions Employer (filled with nominal) Participants Total Contribution Fund

Notes:
*If the business plan submission is for the years 2015 - 2017, then 20XX-1 is the year 2014 (current year), 20XX is the year 2015, etc. No. DESCRIPTION Actual Projection Projection Year 1 Jan-Sept 20XX1 2 Jan-Dec 20XX1 2 Jan-Mar 20XX 2 Jan-Jun 20XX 2 Jan-Sep 20XX 2 Jan-Dec 20XX 2 Jan-Dec 20XX+1 3 Jan-Dec 20XX+2 3 20XX1 1 20XX-1 1 Interest Rate Assumption 2 Actuarial Calculation Method Assumption 3 Mortality Rate Assumption 4 Investment Return Rate 5 etc. (other relevant assumptions)

Investment Plan
a. Investment Composition
No. Investment Type Actual Projection Year 1 As of 30 sept 20xx-1 As of 31 des 20xx-1 As of mar 20xx As of jun 20xx As of sep 20xx* As of des 20xx As of 31 des 20xx+ As of 31 des 20xx+ Etc. b. Investment Results No. Investment Type Actual Projection Year 1 As of 30 sept 20xx-1 As of 31 des 20xx-1 As of mar 20xx As of jun 20xx As of sep 20xx* As of des 20xx As of des 20xx+1 As of 31 des 20xx+ Etc.
Organizational and Human Resources Development Plan
a. Human Resources Quantity Requirements Plan No Level Position Number of HR As of 30 Sept 20XX-1 Recruitment to be Implemented Quarter IV 20XX-1 Quarter I 20XX Quarter II 20XX Quarter III 20XX Quarter IV 20XX Increase Decrease Increase Decrease Increase Decrease Increase Decrease Increase Decrease Etc Total

b. Human Resources Education and Training Implementation Plan for Managers, Acting Managers, and the Supervisory Board No. Material/Topic Participants Training Time Etc

Office Network Development and/or Change Plan
Office network development and/or change plans must at least include plans for opening and merging offices outside the head office. No. Office Type Implementation Time 1 Location 2 Notes 3 A. Opening B. Status Change
C. Merger
D. Address Relocation
Etc
E. Office Closure
Etc

Notes:
1 Filled with the month of the planned implementation time. 2 For locations within the DKI Jakarta region, at least the name of the province DKI Jakarta must be mentioned. For locations outside the DKI Jakarta region, at least the name of the Regency/City must be included. 3 Detailed notes can be attached in a separate sheet.

F. Marketing Policies and Plans (For DPLK Only) No. New Investment Package Name Marketing Channels Plan for issuance/implementation Etc.

G. Report on Plans and Realization of Activities to Improve Financial Literacy for Consumers and/or the Public The format for the Report on Plans and Realization of Activities to Improve 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 Improve Financial Literacy in the Financial Services Sector.

H. Report on Plans and Realization of Activities to Improve Financial Inclusion for Consumers and/or the Public The format for the Report on Plans and Realization of Activities to Improve Financial Inclusion 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 Improve Financial Inclusion in the Financial Services Sector.

I. Information Technology System Development Plan
Detail the plan for the use of information technology used by the company to support business activities. No. Application Type/Name Ownership (In-house/vendor) Vendor Name Application Function

J. Other Information
Other information must at least include information that needs to be reported because it affects the business activities of the Pension Fund, which is not mentioned in the scope of the Business Plan. Examples:

merger and separation plans;

This copy is consistent with the original Legal Director 1 Legal Department signature Yuliana
2. portfolio transfer plans;
3. plans to change business activities not based on Sharia principles to be based on Sharia principles.

F. Report on Data Updating Plans and Realization of Data Updating for Customers as Referred to in the Financial Services Authority Regulation regarding the Implementation of Anti-Money Laundering Programs and Counter-Terrorism Financing in the Financial Services Sector G. Proof of announcement of annual financial statements audited by public accountants on the DPLK website and/or daily newspapers in Indonesian circulating nationally

Established in Jakarta on 5 March 2019 EXECUTIVE HEAD OF INSURANCE, PENSION FUNDS, FINANCING INSTITUTIONS, AND OTHER FINANCIAL SERVICES INSTITUTIONS FINANCIAL SERVICES AUTHORITY, signature RISWINANDI

Form and Structure of Periodic Reports for Pension Funds

Normal Contribution

TOTAL
INVESTMENTS

Vehicles -
Computer
Equipment

Office
Equipment

DESCRIPTION
Actual
Actual
Projection
Projection
Year 1
Jan-Sept
Jan-Dec
Jan-Mar
20XX*
Jan-Jun
20XX*
Jan-Sep
20XX*
Jan-Dec
20XX*
Jan-Dec
20XX
+1*
Jan-31
Dec
20XX+
20XX1*
20XX1*
Other Investment
Income

Total
Investment
Income
INVESTMENT
EXPENSES
Transaction
Expenses
Maintenance
Expenses for Land and
Buildings

Depreciation
Expenses for Buildings

Investment
Manager
Expenses
Custodian
Expenses
Other Investment
Expenses
Total Investment
Expenses
INVESTMENT
RESULTS

OPERATIONAL
EXPENSES

Salaries/Honoraria for Employees,
Managers, and
Supervisory Board
Office Expenses

Maintenance
Expenses
Depreciation
Expenses
Third-Party Service
Expenses
Other Operational
Expenses
Total Operational
Expenses
OTHER INCOME
AND EXPENSES

Late Payment
Interest
Profit (Loss) from Sale of
Operational Assets

DESCRIPTION
Actual
Actual
Projection
Projection
Year 1
Jan-Sept
Jan-Dec
Jan-Mar
20XX*
Jan-Jun
20XX*
Jan-Sep
20XX*
Jan-Dec
20XX*
Jan-Dec
20XX
+1*
Jan-31
Dec
20XX+
20XX1*
20XX1*
Profit (Loss) from Sale of
Other Assets

TOTAL INVESTMENTS

Lineage: Superseded

Timeline

Form and Structure of Periodic Reports for Pension Funds

Normal Contribution

TOTAL INVESTMENTS

Vehicles - Computer Equipment

Office Equipment

DESCRIPTION Actual Actual Projection Projection Year 1 Jan-Sept Jan-Dec Jan-Mar 20XX* Jan-Jun 20XX* Jan-Sep 20XX* Jan-Dec 20XX* Jan-Dec 20XX +1* Jan-31 Dec 20XX+ 20XX1* 20XX1* Other Investment Income

Total Investment Income INVESTMENT EXPENSES Transaction Expenses Maintenance Expenses for Land and Buildings

Depreciation Expenses for Buildings

Investment Manager Expenses Custodian Expenses Other Investment Expenses Total Investment Expenses INVESTMENT RESULTS

OPERATIONAL EXPENSES

Salaries/Honoraria for Employees, Managers, and Supervisory Board Office Expenses

Maintenance Expenses Depreciation Expenses Third-Party Service Expenses Other Operational Expenses Total Operational Expenses OTHER INCOME AND EXPENSES

Late Payment Interest Profit (Loss) from Sale of Operational Assets

DESCRIPTION Actual Actual Projection Projection Year 1 Jan-Sept Jan-Dec Jan-Mar 20XX* Jan-Jun 20XX* Jan-Sep 20XX* Jan-Dec 20XX* Jan-Dec 20XX +1* Jan-31 Dec 20XX+ 20XX1* 20XX1* Profit (Loss) from Sale of Other Assets

TOTAL INVESTMENTS

Lineage: Superseded

Timeline

TOTAL
INVESTMENTS

Vehicles -
Computer
Equipment

Office
Equipment

DESCRIPTION
Actual
Actual
Projection
Projection
Year 1
Jan-Sept
Jan-Dec
Jan-Mar
20XX*
Jan-Jun
20XX*
Jan-Sep
20XX*
Jan-Dec
20XX*
Jan-Dec
20XX
+1*
Jan-31
Dec
20XX+
20XX1*
20XX1*
Other Investment
Income

Total
Investment
Income
INVESTMENT
EXPENSES
Transaction
Expenses
Maintenance
Expenses for Land and
Buildings

Depreciation
Expenses for Buildings

Investment
Manager
Expenses
Custodian
Expenses
Other Investment
Expenses
Total Investment
Expenses
INVESTMENT
RESULTS

OPERATIONAL
EXPENSES

Salaries/Honoraria for Employees,
Managers, and
Supervisory Board
Office Expenses

Maintenance
Expenses
Depreciation
Expenses
Third-Party Service
Expenses
Other Operational
Expenses
Total Operational
Expenses
OTHER INCOME
AND EXPENSES

Late Payment
Interest
Profit (Loss) from Sale of
Operational Assets

DESCRIPTION
Actual
Actual
Projection
Projection
Year 1
Jan-Sept
Jan-Dec
Jan-Mar
20XX*
Jan-Jun
20XX*
Jan-Sep
20XX*
Jan-Dec
20XX*
Jan-Dec
20XX
+1*
Jan-31
Dec
20XX+
20XX1*
20XX1*
Profit (Loss) from Sale of
Other Assets