Monthly Report of Guarantee Companies, Sharia Guarantee Companies, and Sharia Business Units

To:

Board of Directors of Guarantee Companies;
Board of Directors of Sharia Guarantee Companies; and
Board of Directors of Guarantee Companies with Sharia Business Units,
At your location.

COPY
CIRCULAR LETTER OF THE FINANCIAL SERVICES AUTHORITY REPUBLIC OF INDONESIA NUMBER 1 /SEOJK.05/2023 CONCERNING MONTHLY REPORTS OF GUARANTEE COMPANIES, SHARIA GUARANTEE COMPANIES, AND SHARIA BUSINESS UNITS

In accordance with the mandate of Article 2 paragraph (6), Article 4 paragraph (6), and Article 10 of the Financial Services Authority Regulation Number 3/POJK.05/2013 concerning Monthly Reports of Non-Bank Financial Institutions (State Gazette of the Republic of Indonesia Year 2013 Number 150, Supplement to the State Gazette of the Republic of Indonesia Number 5443) and considering changes in relevant financial accounting standards for guarantee companies, Sharia guarantee companies, and Sharia business units, it is necessary to regulate provisions regarding monthly reports for guarantee companies, Sharia guarantee companies, and Sharia business units in this Financial Services Authority Circular as follows:

I. GENERAL PROVISIONS
In this Financial Services Authority Circular, the following terms are defined:

Guarantee Company is a legal entity operating in the financial sector with its main business activity being guarantee provision as referred to in Law Number 1 of 2016 concerning Guarantees.
Sharia Guarantee Company is a legal entity operating in the financial sector with its main business activity being Sharia guarantee provision as referred to in Law Number 1 of 2016 concerning Guarantees.
Sharia Business Unit (hereinafter referred to as UUS) is a work unit of a Guarantee Company functioning as the head office of offices or units carrying out guarantee business activities based on Sharia principles as referred to in Law Number 1 of 2016 concerning Guarantees.
Monthly Report of the Company (hereinafter referred to as Monthly Report) is a financial report prepared by the company for the benefit of the Financial Services Authority, covering the period from the 1st to the end of the relevant month, presented and submitted to the Financial Services Authority according to the format and procedures determined by the Financial Services Authority.
Board of Directors refers to the Board of Directors as referred to in Law Number 40 of 2007 concerning Limited Liability Companies for Guarantee Institutions in the form of limited liability companies or equivalent to the Board of Directors for Guarantee Institutions in the form of state-owned enterprises or cooperatives.

II. FORM, STRUCTURE, AND GUIDELINES FOR PREPARING MONTHLY REPORTS

Monthly Reports consist of:
a. statement of financial position; b. comprehensive income statement, currently known as the income statement and other comprehensive income statement;
c. cash flow statement;
d. asset and liability matching analysis report; and e. other reports.
The preparation of Monthly Reports refers to the general explanation of Monthly Report preparation as contained in Appendix I, which is an integral part of this Financial Services Authority Circular.
The form and structure of Monthly Reports:
a. for Guarantee Companies are as contained in Appendix II, which is an integral part of this Financial Services Authority Circular; and b. for Sharia Guarantee Companies and UUS are as contained in Appendix III, which is an integral part of this Financial Services Authority Circular.

III. SUBMISSION TIME OF MONTHLY REPORTS

Guarantee Companies, Sharia Guarantee Companies, and UUS are required to submit Monthly Reports to the Financial Services Authority no later than the 10th of the following month.
In the event that the 10th date as referred to in paragraph 1 falls on a holiday, the Monthly Report must be submitted on the next working day.
In the event that the submission date of the Monthly Report as referred to in paragraph 1 or paragraph 2 falls on a national holiday or combined holiday, the Financial Services Authority has the authority to determine the submission deadline for the Monthly Report.

IV. BOARD OF DIRECTORS MEMBERS RESPONSIBLE AND REPORT PREPARATION OFFICERS

Guarantee Companies or Sharia Guarantee Companies appoint a Board of Directors member responsible for the preparation and presentation of Monthly Reports.
The Board of Directors member as referred to in paragraph 1 appoints report preparation officers to prepare, verify, and submit Monthly Reports.
Guarantee Companies or Sharia Guarantee Companies must report changes to the Board of Directors member as referred to in paragraph 1 and/or report preparation officers as referred to in paragraph 2 to the Financial Services Authority according to Format 1 as contained in Appendix IV, which is an integral part of this Financial Services Authority Circular.

V. SUBMISSION PROCEDURES

In submitting Monthly Reports, the report preparation officer as referred to in Roman IV paragraph 2 must have a user ID and password.
To obtain the user ID and password as referred to in paragraph 1, the Board of Directors member must submit a request according to Format 2 as contained in Appendix IV, which is an integral part of this Financial Services Authority Circular.
In the event that Guarantee Companies, Sharia Guarantee Companies, and UUS make changes to report preparation officers as referred to in Roman IV paragraph 3, the Board of Directors member of the Guarantee Company or Sharia Guarantee Company must submit a request to obtain and/or change the user ID and password as referred to in paragraph 2 according to Format 3 as contained in Appendix IV, which is an integral part of this Financial Services Authority Circular.
Submission of Monthly 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 paragraph 4 is not yet available, experiences technical problems, or Guarantee Companies, Sharia Guarantee Companies, and UUS experience disturbances preventing online submission of Monthly Reports, Monthly Reports are submitted offline in the form of electronic copies (soft files) accompanied by validation proof and sent to the Financial Services Authority via a letter signed by a Board of Directors member and addressed to:
a. for Guarantee Companies:
Executive Head of Insurance, Pension Funds, Financing Institutions, and Other Financial Services Supervision Financial Services Authority u.p. Director of Special Financial Institution Supervision Wisma Mulia 2 Building, 15th Floor Jalan Jenderal Gatot Subroto Kav. 40 Jakarta 12710; or b. for Sharia Guarantee Companies and UUS:
Executive Head of Insurance, Pension Funds, Financing Institutions, and Other Financial Services Supervision Financial Services Authority u.p. Director of Sharia Special Financial Institutions (IKNB Syariah) Wisma Mulia 2 Building, 12th Floor Jalan Jenderal Gatot Subroto Kav. 40 Jakarta 12710.
Offline submission of monthly reports in the form of electronic copies (soft files) as referred to in paragraph 5 is submitted in the form of data recordings stored on compact discs or other electronic data recording media.
In the event of changes to the Financial Services Authority's office address as referred to in paragraph 5, the Financial Services Authority communicates such address changes via letter, announcement, or other communication media.
Offline submission of Monthly Reports as referred to in paragraph 5 can be done by:
a. being handed directly to the Financial Services Authority office; or b. being sent via a courier service company.
Offline submission of Monthly Reports is submitted to the Financial Services Authority on working days and during Financial Services Authority working hours.
Guarantee Companies, Sharia Guarantee Companies, and UUS are deemed to have submitted Monthly Reports with the following provisions:
a. for online submission through the Financial Services Authority's data communication network system, evidenced by a receipt from the Financial Services Authority's data communication network system; or b. for offline submission, evidenced by a receipt from the Financial Services Authority.

VI. CLOSING

The obligation of Guarantee Companies, Sharia Guarantee Companies, and UUS to submit Monthly Reports according to the form, structure, and submission procedures regulated in this Financial Services Authority Circular begins for the reporting period of January 2023, with submission timing as referred to in Roman III.
Guarantee Companies, Sharia Guarantee Companies, and UUS submit guaranteed data receiving guarantees in the detail of guarantee closure details no later than within 12 (twelve) months after this Financial Services Authority Circular takes effect.

This copy is consistent with the original
Director of Law 1
Legal Department signed
Mufli Asmawidjaja

At the time this Financial Services Authority Circular takes effect, Financial Services Authority Circular Number 11/SEOJK.05/2013 concerning Monthly Reports of Credit Guarantee Companies is revoked and declared invalid.
This Financial Services Authority Circular takes effect on the date determined.

Determined in Jakarta on January 6, 2023
EXECUTIVE HEAD OF INSURANCE, PENSION FUNDS,
FINANCING INSTITUTIONS, AND
OTHER FINANCIAL SERVICES SUPERVISION
FINANCIAL SERVICES AUTHORITY
REPUBLIC OF INDONESIA,

signed
OGI PRASTOMIYONO

APPENDIX I
CIRCULAR LETTER OF THE FINANCIAL SERVICES AUTHORITY REPUBLIC OF INDONESIA NUMBER 1 /SEOJK.05/2023 CONCERNING MONTHLY REPORTS OF GUARANTEE COMPANIES, SHARIA GUARANTEE COMPANIES, AND SHARIA BUSINESS UNITS

TABLE OF CONTENTS
GENERAL EXPLANATION 2

Reporting Objectives 2
Reporting Principles 2
Filling Out Report Forms 2

GENERAL EXPLANATION
PREPARATION OF REPORTS
GENERAL EXPLANATION

Reporting Objectives
Monthly Reports prepared according to the systematics established in this Appendix are intended to collect and compile statistical data of Guarantee Companies, Sharia Guarantee Companies, and UUS individually or collectively in order to:
a. regulate and supervise Guarantee Companies, Sharia Guarantee Companies, and UUS; b. form statistics for the purpose of analyzing the non-bank financial industry; and
c. fulfill internal needs of Guarantee Companies, Sharia Guarantee Companies, and UUS,
to achieve these objectives, Guarantee Companies, Sharia Guarantee Companies, and UUS submit reports accurately, completely, and within the established time limits.
Reporting Principles
This reporting system adheres to basic preparation principles referring to regulations established by the Financial Services Authority and Financial Accounting Standards Statements (PSAK) as well as Financial Accounting Standards Interpretations (ISAK). Accounting transactions of Guarantee Companies, Sharia Guarantee Companies, and UUS are implemented in accordance with relevant financial accounting standards for Guarantee Companies, Sharia Guarantee Companies, and Sharia Business Units.
Filling Out Report Forms
Filling out report forms is done by entering data automatically in alphanumeric form

This copy is consistent with the original
Director of Law 1
Legal Department signed
Mufli Asmawidjaja using data entry programs and all financial reports are presented in full Rupiah units. Determined in Jakarta on January 6, 2023 EXECUTIVE HEAD OF INSURANCE, PENSION FUNDS, FINANCING INSTITUTIONS, AND OTHER FINANCIAL SERVICES SUPERVISION FINANCIAL SERVICES AUTHORITY,

signed
OGI PRASTOMIYONO

APPENDIX II
CIRCULAR LETTER OF THE FINANCIAL SERVICES AUTHORITY REPUBLIC OF INDONESIA NUMBER 1 /SEOJK.05/2023 CONCERNING MONTHLY REPORTS OF GUARANTEE COMPANIES, SHARIA GUARANTEE COMPANIES, AND SHARIA BUSINESS UNITS

TABLE OF CONTENTS
TABLE OF CONTENTS................................................................................................. 2
I. GUARANTEE COMPANY PROFILE REPORT................................... 4
A. FORM 0000 GUARANTEE COMPANY PROFILE ................ 4
B. FORM 0020: BRANCH OFFICE DETAILS.............................. 9
C. FORM 0030: EMPLOYEE COUNT DETAILS.......................... 12
II. FINANCIAL REPORTS OF GUARANTEE COMPANIES.......................... 14
A. FORM 1100 (STATEMENT OF FINANCIAL POSITION) ....................... 14
B. FORM 1200: COMPREHENSIVE INCOME STATEMENT ......... 32
C. FORM 1300 (CASH FLOW STATEMENT)..................................... 39
D. FORM 2100: LIST OF INVESTMENT ASSET DETAILS ............... 45
E. FORM 2200: LIST OF IJP RECEIVABLES DETAILS...................... 63
F. FORM 2300: LIST OF CO-GUARANTEE AND REINSURANCE/RE-GUARANTEE RECEIVABLES DETAILS ........ 66
G. FORM 2400: LIST OF OTHER ASSETS DETAILS....................... 70
H. FORM 2500: LIST OF FIXED ASSETS – NET DETAILS.......... 71
I. FORM 2600: LIST OF COMMISSION PAYABLES DETAILS.................. 72
J. FORM 2700: LIST OF CO-GUARANTEE CLAIM PAYABLES DETAILS............................................................................... 75
K. FORM 2800: LIST OF IJP CO-GUARANTEE AND REINSURANCE/RE-GUARANTEE PAYABLES DETAILS .................................. 77
L. FORM 2900: LIST OF OTHER LIABILITIES DETAILS ....... 82
M. FORM 3000: LIST OF MANDATORY CONVERSION OBLIGATIONS.................................................................................................. 83
N. FORM 3100: LIST OF GUARANTEES DETAILS..................... 85
O. FORM 3200: LIST OF GUARANTEE CLAIM REPORTS PER GUARANTEED LOCATION ....................................... 89
P. FORM 3300: LIST OF GUARANTEE CLAIM REPORTS PER GUARANTEE RECIPIENT LOCATION ....................... 99
Q. FORM 3400: LIST OF GUARANTEE CLAIM REPORTS PER ECONOMIC SECTOR..................................... 108

R. FORM 3500: LIST OF GUARANTEE CLAIM REPORTS PER GUARANTEE RECIPIENT.................................. 117
S. FORM 4100: ASSET AND LIABILITY MATCHING ANALYSIS REPORT............................................................................... 134
T. FORM 5100: OPERATIONAL PERFORMANCE OF GUARANTEE COMPANIES ........................................................................... 135
U. FORM 6100: SUBROGATION RECEIVABLES REPORT.................. 137
V. FORM 7100: GEARING RATIO REPORT........................... 138
W. FORM 8100: CREDIT GUARANTEE QUALITY REPORT .139
X. FORM 9100: TOP 10 NON PERFORMING GUARANTEE/NPG REPORT .................................................................... 140

I. GUARANTEE COMPANY PROFILE REPORT
A. FORM 0000 GUARANTEE COMPANY PROFILE

FORM 0000 (GUARANTEE COMPANY PROFILE) FORM
FORM 0000 GUARANTEE COMPANY PROFILE is prepared according to the following format:
GUARANTEE COMPANY PROFILE a. Company Name b. Taxpayer Identification Number (NPWP)
c. Office Address
d. Company Ownership Status e. Legal Entity Form f. Establishment Date g. Type of Business Activity Conducted h. Reporting Period
i. Company Organ

Number of Commissioners
Number of Directors
Number of Sharia Supervisory Board
j. Name of Sharia Business Unit (UUS) Leader k. Office Network Data
Head Office
UUS Office
Branch Office
l. Employee Count
Head Office
UUS Office
Branch Office
m. Report Preparation and Responsible Person
Report Preparation Officer
a) Full Name b) Position c) Telephone Number d) Mobile Phone Number e. Electronic Mail Address (E-mail)
Responsible Person for Report
a) Full Name b) Position c) Telephone Number d) Mobile Phone Number e. Electronic Mail Address (E-mail)

EXPLANATION OF FORM 0000 (GUARANTEE COMPANY PROFILE)
FORM 0000 GUARANTEE COMPANY PROFILE contains all information regarding the Company profile. a. Company Name This position is filled with the name of the Guarantee Company including its legal entity form. b. Taxpayer Identification Number (NPWP) This position is filled with the Guarantee Company's NPWP.
c. Office Address
This position is filled with the complete address of the Guarantee Company's head office. d. Company Ownership Status This position is filled with the following information:

State-Owned Company, in the event that the Guarantee Company is owned by the state either through capital participation by the central government or capital participation by the regional government;
National Private Company, in the event that the Guarantee Company is not owned by the state and there is no participation, either directly or indirectly, by foreign parties; or
Joint Venture Private Company, in the event that there is participation, either directly or indirectly, by foreign parties in the Guarantee Company.
e. Legal Entity Form
This position is filled with the legal entity form of the Guarantee Company as per Article 2 of the Financial Services Authority Regulation Number 1/POJK.05/2017 concerning Business Licensing and Institutional Structure of Guarantee Institutions.

f. Establishment Date
This position is filled with the date, month, and year of establishment of the Guarantee Company. g. Type of Business Activity Conducted This position is filled with the name of the guarantee business in guarantee as per Article 2 of the Financial Services Authority Regulation Number 2/POJK.05/2017 concerning the Conduct of Business by Guarantee Institutions, as amended by the Financial Services Authority Regulation Number 30/POJK.05/2018 concerning Amendment to the Financial Services Authority Regulation Number 2/POJK.05/2017 concerning the Conduct of Business by Guarantee Institutions. h. Reporting Period This position is filled with the end date of the reporting period, for example, January 31, 2023.
i. Company Organ
This position is filled with the number of commissioners, number of Directors, and number of Sharia Supervisory Board members in the Guarantee Company. j. UUS Leader Name This position is filled with the name of the UUS leader. k. Office Network Data This position is filled with the number of office networks covering:

Head Office;
UUS Office; and
Branch Office.
This position is detailed in FORM 0020: BRANCH OFFICE DETAILS.
l. Employee Count
This position is filled with the number of employees owned by the Guarantee Company covering all employees at:
Head Office;
UUS Office; and
Branch Office.

This position is detailed in FORM 0030: EMPLOYEE COUNT DETAILS. m. Report Preparation and Responsible Person

Report Preparation Officer
This position is filled with complete data of Guarantee Company personnel acting as report preparation officers. a) Full Name This position is filled with the full name of the report preparation officer. b) Position This position is filled with the position of the report preparation officer. c) Telephone Number This position is filled with the telephone number of the department/division/unit of the Board of Directors member responsible for the report. d) Mobile Phone Number This position is filled with the mobile phone number of the report preparation officer. e. Electronic Mail Address (E-mail) This position is filled with the e-mail address of the report preparation officer
Responsible Person for Report
This position is filled with complete data of the Board of Directors member acting as the responsible person for the report. a) Full Name This position is filled with the name of the Board of Directors member responsible for the report. b) Position This position is filled with the position of the Board of Directors member responsible for the report. c) Telephone Number This position is filled with the telephone number of the department/division/unit of the Board of Directors member responsible for the report. d) Mobile Phone Number

This position is filled with the mobile phone number of the Board of Directors member responsible for the report. e. Electronic Mail Address (E-mail) This position is filled with the e-mail address of the Board of Directors member responsible for the report.

B. FORM 0020: BRANCH OFFICE DETAILS

FORM 0020 (BRANCH OFFICE DETAILS) FORM
FORM 0020: BRANCH OFFICE DETAILS is prepared according to the following format:

Office Type
Registration Letter Number
Date of Registration Letter
4)
Location a. Address b.
District c.
Regency/City d. Postal Code
5) 6) 7) 8) 9)
Telephone Number
Number of
Workforce
Name of
Office Responsible Person
Date of
Start of Operations
Office Building
Ownership
10)
Employee Count a. Male b. Female

EXPLANATION OF FORM 0020 (BRANCH OFFICE DETAILS)
FORM 0020: BRANCH OFFICE DETAILS contains branch office information as follows:

Office Type
This position is filled with the name designation of the branch office.
Registration Letter Number
This position is filled with the letter number from the Financial Services Authority regarding the registration of the branch office.
Date of Registration Letter
This position is filled with the date of the letter from the Financial Services Authority regarding the registration of the opening of the branch office.
Location
a. Address
This position is filled with the complete address of the branch office. b. District This position is filled with the name of the district where the branch office is located.
c. Regency/City
This position is filled with the location of the regency/city where the branch office is located. d. Postal Code This position is filled with the postal code number of the branch office location.
Telephone Number
This position is filled with the area code and telephone number of each branch office.
Number of Workforce
This position is filled with the number of workforce located at the office other than the head office, including the branch office responsible person, permanent workforce, contract workforce, and outsourcing contract workforce.
Name of Office Responsible Person
This position is filled with the name of the responsible person for each branch office.
Date of Start of Operations
This position is filled with the date the branch office started operations.
Office Building Ownership
This position is filled with the status of office building ownership, for example, owned by the Guarantee Company or rented.
Employee Count
a. Male

This position is filled with the number of employees of male gender. b. Female This position is filled with the number of employees of female gender.

C. FORM 0030: EMPLOYEE COUNT DETAILS

FORM 0030 (EMPLOYEE COUNT DETAILS) FORM
FORM 0030: EMPLOYEE COUNT DETAILS is prepared according to the following format:

Employment Status
Conventional Sharia a.
Male b.
Female a.
Male b.
Female a. Permanent
Employee b. Contract
Employee
c. Outsourced
Employee
Total

EXPLANATION OF FORM 0030 (EMPLOYEE COUNT DETAILS)
Form 0030 (EMPLOYEE COUNT DETAILS)
FORM 0030: EMPLOYEE COUNT DETAILS contains information on the number of employees based on employment status, namely permanent employees, contract employees, or outsourced workforce at Guarantee Companies and/or UUS.

Employment Status
a. Permanent Employees
This position is filled with the number of permanent employees owned by the Guarantee Company. b. Contract Employees This position is filled with the number of contract employees owned by the Guarantee Company.
c. Outsourced Employees
This position is filled with the number of outsourced employees owned by the Guarantee Company.
Conventional
This position is filled with the number of employees owned by the Guarantee Company based on their employment status. a. Male This position is filled with the number of employees of male gender based on their employment status. b. Female This position is filled with the number of employees of female gender based on their employment status.
Sharia
This position is filled with the number of employees owned/employed at UUS based on their employment status. a. Male This position is filled with the number of employees of male gender based on their employment status. b. Female This position is filled with the number of employees of female gender based on their employment status.

II. GUARANTEE COMPANY FINANCIAL STATEMENTS
A. FORM 1100 (STATEMENT OF FINANCIAL POSITION)

FORM 1100 (STATEMENT OF FINANCIAL POSITION) FORMAT
FORM 1100 (STATEMENT OF FINANCIAL POSITION) is prepared in the following format:

Position	Amount
a. ASSETS
1) Current Assets
a) Cash and Bank Deposits
b) Investments
i. Bank Deposits
ii. Government Securities
iii. Securities Issued by Bank Indonesia
iv. Corporate Bonds
v. Shares Listed on the Indonesia Stock Exchange
vi. Asset-Backed Securities
vii. Mutual Funds
viii. Medium Term Notes
ix. Repurchase Agreement
x. Real Estate Investment Funds in the Form of Collective Investment Contracts
xi. Land and Buildings
xii. Direct Investments in Companies in the Financial Services Sector in Indonesia
xiii. Regional Bonds
xiv. Infrastructure Investment Funds in the Form of Collective Investment Contracts
xv. Others
c) Guarantee Service Fee Receivables (Guarantee Service Fee Receivables)
d) Co-Guarantee Receivables
e) Reinsurance/Re-guarantee Receivables
f) Accrued Income
g) Prepaid Expenses
h) Receivables in the Framework of Guarantee Restructuring
i) Deferred Tax Assets
j) Fixed Assets – Net
k) Intangible Assets – Net
l) Other Assets
Total Current Assets
2) Non-Current Assets
a) Investments
i. Bank Deposits
ii. Government Securities
iii. Securities Issued by Bank Indonesia
iv. Corporate Bonds
v. Shares Listed on the Indonesia Stock Exchange
vi. Asset-Backed Securities
vii. Mutual Funds
viii. Medium Term Notes
ix. Repurchase Agreement
x. Real Estate Investment Funds in the Form of Collective Investment Contracts
xi. Land and Buildings
xii. Direct Investments in Companies in the Financial Services Sector in Indonesia
xiii. Regional Bonds
xiv. Infrastructure Investment Funds in the Form of Collective Investment Contracts
xv. Others
b) Guarantee Service Fee Receivables
c) Co-Guarantee Receivables
d) Reinsurance/Re-guarantee Receivables
e) Accrued Income
f) Prepaid Expenses
g) Receivables in the Framework of Guarantee Restructuring
h) Deferred Tax Assets
i) Fixed Assets – Net
j) Intangible Assets – Net
k) Other Assets
Total Non-Current Assets
b. LIABILITIES
1) Current Liabilities
a) Claims Payable
b) Claim Reserves
c) Guarantee Service Fee Accumulation
d) Deferred Guarantee Service Fee
e) Tax Payables
f) Commission Payables
g) Co-Guarantee Claims Payable
h) Co-Guarantee Guarantee Service Fee Payable
i) Reinsurance Premium/Re-guarantee Guarantee Service Fee Payable
j) Accrued Expenses
k) Deferred Tax Liabilities
l) Mandatory Convertible Bonds
m) Post-Employment Benefits Liabilities
n) Other Liabilities
Total Current Liabilities
2) Non-Current Liabilities
a) Claims Payable
b) Guarantee Service Fee Accumulation
c) Deferred Guarantee Service Fee
d) Tax Payables
e) Commission Payables
f) Co-Guarantee Claims Payable
g) Co-Guarantee Guarantee Service Fee Payable
h) Reinsurance Premium/Re-guarantee Guarantee Service Fee Payable
i) Accrued Expenses
j) Deferred Tax Liabilities
k) Mandatory Convertible Bonds
l) Post-Employment Benefits Liabilities
m) Other Liabilities
Total Non-Current Liabilities
c. EQUITY
1) Capital
a) Paid-in Capital
b) Advance Capital Deposits
2) Reserves
a) General Reserve
b) Specific Reserve
c) Other Reserves
3) Grants
4) Retained Earnings/(Accumulated Losses)
5) Profit/(Loss) for the Current Year
6) Other Comprehensive Income
Total Equity

EXPLANATION OF FORM 1100 (STATEMENT OF FINANCIAL POSITION)
FORM 1100 (STATEMENT OF FINANCIAL POSITION) contains the financial position report of the Guarantee Company, providing detailed explanations of asset positions, liability positions, and equity positions, as follows:

a. ASSETS

1) Current Assets
Current assets are assets that will be realized, or are intended to be sold or used, in the normal operating cycle, for trading purposes, or are expected to be realized within 12 (twelve) months after the reporting date by the Guarantee Company.

a) Cash and Bank Deposits
This position is filled with the amount of cash in hand in the form of banknotes and coins that are legal tender in Indonesia, as well as giro funds in banks. The definition of cash also includes foreign banknotes and coins that are still valid as legal tender.

b) Investments
This position is filled with fund placements made by the Guarantee Company in the form of:
i. Bank Deposits
ii. Government Securities
iii. Securities Issued by Bank Indonesia
iv. Corporate Bonds
v. Shares Listed on the Indonesia Stock Exchange
vi. Asset-Backed Securities
vii. Mutual Funds
viii. Medium Term Notes
ix. Repurchase Agreement
x. Real Estate Investment Funds in the Form of Collective Investment Contracts
xi. Land and Buildings
xii. Direct Investments in Companies in the Financial Services Sector in Indonesia
xiii. Regional Bonds
xiv. Infrastructure Investment Funds in the Form of Collective Investment Contracts
xv. Others,
which are permitted in accordance with applicable regulations.
This position is detailed in FORM 2100: LIST OF INVESTMENT ASSET DETAILS.

c) Guarantee Service Fee Receivables (Guarantee Service Fee Receivables) This position is filled with Guarantee Service Fee receivables from the Indonesian Government, both central and regional, in connection with guarantee business activities that are government-assigned programs, such as the Guarantee of the People's Business Credit (KUR) program. Guarantee Companies receiving assignments from the government must prove this with evidence of assignment. This position is detailed in FORM 2200: LIST OF GUARANTEE SERVICE FEE RECEIVABLES DETAILS.

d) Co-Guarantee Receivables
This position is filled with receivables from co-guarantee partners in connection with claim payments that are the responsibility of the co-guarantee partner. This position is detailed in FORM 2300: LIST OF CO-GUARANTEE AND REINSURANCE/RE-GUARANTEE RECEIVABLES DETAILS.

e) Reinsurance/Re-guarantee Receivables
This position is filled with receivables from reinsurance or re-guarantee partners in connection with claim payments that are the responsibility of the reinsurance partner or re-guarantee company. This position is detailed in FORM 2300: LIST OF CO-GUARANTEE AND REINSURANCE/RE-GUARANTEE RECEIVABLES DETAILS.

f) Accrued Income
This position is filled with income of the Guarantee Company that has been recognized in the reporting period but payment has not yet been received, such as income from bank deposit interest that has not yet been received.

g) Prepaid Expenses
This position is filled with payments for goods and/or services that will be used or provide benefits in the future. Several items included in the prepaid expenses category include prepaid rent, prepaid reinsurance Guarantee Service Fee, prepaid co-guarantee Guarantee Service Fee, and prepaid insurance.

h) Receivables in the Framework of Guarantee Restructuring This position is filled with loans provided by the Guarantee Company in the framework of guarantee restructuring.

i) Deferred Tax Assets
This position is filled with the amount of recoverable income tax in future periods as a result of deductible temporary differences and remaining loss compensation.

j) Fixed Assets – Net
This position is filled with tangible assets owned by the Guarantee Company and used in operational activities in accordance with applicable financial accounting standards. This position is detailed in FORM 2500: LIST OF FIXED ASSETS – NET DETAILS.

k) Intangible Assets – Net
This position is filled with identifiable assets that do not have a physical form and are owned by the Guarantee Company for use in operational activities. This position is presented net after considering the accumulated amortization of intangible assets.

l) Other Assets
This position is filled with other assets that cannot be classified into any of the positions from letter a to letter k above. This position is detailed in FORM 2400: LIST OF OTHER ASSETS DETAILS.

2) Non-Current Assets
Non-current assets are assets that will be realized, or are intended to be sold or used, in the normal operating cycle, for trading purposes, or are expected to be realized within a period of more than 12 (twelve) months after the reporting date by the Guarantee Company.

a) Investments
This position is filled with fund placements made by the Guarantee Company in the form of:
i. Bank Deposits
ii. Government Securities
iii. Securities Issued by Bank Indonesia
iv. Corporate Bonds
v. Shares Listed on the Indonesia Stock Exchange
vi. Asset-Backed Securities
vii. Mutual Funds
viii. Medium Term Notes
ix. Repurchase Agreement
x. Real Estate Investment Funds in the Form of Collective Investment Contracts
xi. Land and Buildings
xii. Direct Investments in Companies in the Financial Services Sector in Indonesia
xiii. Regional Bonds
xiv. Infrastructure Investment Funds in the Form of Collective Investment Contracts
xv. Others,
which are permitted in accordance with applicable regulations.
This position is detailed in FORM 2100: LIST OF INVESTMENT ASSET DETAILS.

b) Guarantee Service Fee Receivables
This position is filled with Guarantee Service Fee receivables from the Indonesian Government, both central and regional, in connection with guarantee business activities that are government-assigned programs, such as the Guarantee of the People's Business Credit (KUR) program. Guarantee Companies receiving assignments from the government must prove this with evidence of assignment. This position is detailed in FORM 2200: LIST OF GUARANTEE SERVICE FEE RECEIVABLES DETAILS.

c) Co-Guarantee Receivables
This position is filled with receivables from co-guarantee partners in connection with claim payments that are the responsibility of the co-guarantee partner. This position is detailed in FORM 2300: LIST OF CO-GUARANTEE AND REINSURANCE/RE-GUARANTEE RECEIVABLES DETAILS.

d) Reinsurance/Re-guarantee Receivables
This position is filled with receivables from reinsurance or re-guarantee partners in connection with claim payments that are the responsibility of the reinsurance partner or re-guarantee company. This position is detailed in FORM 2300: LIST OF CO-GUARANTEE AND REINSURANCE/RE-GUARANTEE RECEIVABLES DETAILS.

e) Accrued Income
This position is filled with income of the Guarantee Company that has been recognized in the reporting period but payment has not yet been received, such as income from bank deposit interest that has not yet been received.

f) Prepaid Expenses
This position is filled with payments for goods and/or services that will be used or provide benefits in the future. Several items included in the prepaid expenses category include prepaid rent, prepaid reinsurance Guarantee Service Fee, prepaid co-guarantee Guarantee Service Fee, and prepaid insurance.

g) Receivables in the Framework of Guarantee Restructuring This position is filled with loans provided by the Guarantee Company in the framework of guarantee restructuring.

h) Deferred Tax Assets
This position is filled with the amount of recoverable income tax in future periods as a result of deductible temporary differences and remaining loss compensation.

i) Fixed Assets – Net
This position is filled with tangible assets owned by the Guarantee Company and used in operational activities in accordance with applicable financial accounting standards. This position is detailed in FORM 2500: LIST OF FIXED ASSETS – NET DETAILS.

j) Intangible Assets – Net
This position is filled with identifiable assets that do not have a physical form and are owned by the Guarantee Company for use in operational activities for more than one year. This position is presented net after considering the accumulated amortization of intangible assets.

k) Other Assets
This position is filled with other assets that cannot be classified into any of the positions from letter a to letter j above. This position is detailed in FORM 2400: LIST OF OTHER ASSETS DETAILS.

b. LIABILITIES

1) Current Liabilities
Current liabilities are liabilities that will be settled within 12 (twelve) months after the reporting date by the Guarantee Company.

a) Claims Payable
This position is filled with liabilities arising from the approval of claims submitted by guarantee recipients but not yet paid by the Guarantee Company. Claims payable are recognized and recorded when the claim is approved for payment (claim settled).

b) Claim Reserves
This position is filled with estimates of claims that will become the responsibility of the Guarantee Company, the amount of which is recognized and recorded on the reporting date in accordance with applicable financial accounting standards and considering the formation of minimum claim reserves in accordance with applicable Financial Services Authority Regulations.

c) Guarantee Service Fee Accumulation
This position is filled with Guarantee Service Fee from guarantee recipients that has not yet been identified by the Guarantee Company.

d) Deferred Guarantee Service Fee
This position is filled with the portion of Guarantee Service Fee received by the Guarantee Company that has not yet been recognized as income on the reporting date, which is calculated individually for each guarantee and the amount is set proportionally for each guarantee period. What is included in this position is deferred Guarantee Service Fee.

e) Tax Payables
This position is filled with the amount of taxes due to be paid by the Guarantee Company.

f) Commission Payables
This position is filled with commission payables to other parties in connection with the closing of guarantees. This position is detailed in FORM 2600: LIST OF COMMISSION PAYABLES DETAILS.

g) Co-Guarantee Claims Payable
This position is filled with liabilities in co-guarantee guarantee efforts together with co-guarantee partners. This position is detailed in FORM 2700: LIST OF CO-GUARANTEE CLAIMS PAYABLES DETAILS.

h) Co-Guarantee Guarantee Service Fee Payable This position is filled with premium payables that the Guarantee Company must pay to transfer claim risk. This position is detailed in FORM 2800: LIST OF CO-GUARANTEE GUARANTEE SERVICE FEE PAYABLES AND REINSURANCE/RE-GUARANTEE DETAILS.

i) Reinsurance Premium/Re-guarantee Guarantee Service Fee Payable This position is filled with reinsurance premium/re-guarantee Guarantee Service Fee payables that must be paid by the Guarantee Company to reinsurance companies or re-guarantee companies. This position is detailed in FORM 2800: LIST OF CO-GUARANTEE GUARANTEE SERVICE FEE PAYABLES AND REINSURANCE/RE-GUARANTEE DETAILS.

j) Accrued Expenses
This position is filled with expenses that have occurred but payment has not yet been fulfilled, including salary expenses and rental expenses.

k) Deferred Tax Liabilities
This position is filled with the amount of income tax payable for future periods as a result of taxable temporary differences.

l) Mandatory Convertible Bonds
This position is filled with bonds issued by the Guarantee Company that must be converted into shares based on agreements between the Guarantee Company and bondholders. This position is detailed in FORM 3000: LIST OF MANDATORY CONVERTIBLE BONDS DETAILS.

m) Post-Employment Benefits Liabilities
This position is filled with employment benefits other than termination benefits and equity-based benefits that are payable after workers complete their working period.

n) Other Liabilities
This position is filled with other liabilities that cannot be included or classified into any of the positions from letter a to letter m above. This position is detailed in FORM 2900: LIST OF OTHER LIABILITIES DETAILS.

2) Non-Current Liabilities
Non-current liabilities are liabilities that will be settled within a period of more than 12 (twelve) months after the reporting date by the Guarantee Company.

b) Guarantee Service Fee Accumulation
This position is filled with Guarantee Service Fee from guarantee recipients that has not yet been identified by the Guarantee Company.

c) Deferred Guarantee Service Fee
This position is filled with the portion of Guarantee Service Fee received by the Guarantee Company that has not yet been recognized as income on the reporting date, which is calculated individually for each guarantee and the amount is set proportionally for each guarantee period. What is included in this position is deferred Guarantee Service Fee.

d) Tax Payables
This position is filled with the amount of taxes due to be paid by the Guarantee Company.

e) Commission Payables
This position is filled with commission payables to other parties in connection with the closing of guarantees. This position is detailed in FORM 2600: LIST OF COMMISSION PAYABLES DETAILS.

f) Co-Guarantee Claims Payable
This position is filled with liabilities in co-guarantee guarantee efforts together with co-guarantee partners. This position is detailed in FORM 2700: LIST OF CO-GUARANTEE CLAIMS PAYABLES DETAILS.

g) Co-Guarantee Guarantee Service Fee Payable This position is filled with premium payables that the Guarantee Company must pay to transfer claim risk. This position is detailed in FORM 2800: LIST OF CO-GUARANTEE GUARANTEE SERVICE FEE PAYABLES AND REINSURANCE/RE-GUARANTEE DETAILS.

h) Reinsurance Premium/Re-guarantee Guarantee Service Fee Payable This position is filled with reinsurance premium/re-guarantee Guarantee Service Fee payables that must be paid by the Guarantee Company to reinsurance companies or re-guarantee companies. This position is detailed in FORM 2800: LIST OF CO-GUARANTEE GUARANTEE SERVICE FEE PAYABLES AND REINSURANCE/RE-GUARANTEE DETAILS.

i) Accrued Expenses
This position is filled with expenses that have occurred but payment has not yet been fulfilled, including salary expenses and rental expenses.

j) Deferred Tax Liabilities
This position is filled with the amount of income tax payable for future periods as a result of taxable temporary differences.

k) Mandatory Convertible Bonds
This position is filled with bonds issued by the Guarantee Company that must be converted into shares based on agreements between the Guarantee Company and bondholders. This position is detailed in FORM 3000: LIST OF MANDATORY CONVERTIBLE BONDS DETAILS.

l) Post-Employment Benefits Liabilities
This position is filled with employment benefits other than termination benefits and equity-based benefits that are payable after workers complete their working period.

m) Other Liabilities
This position is filled with other liabilities that cannot be included or classified into any of the positions from letter a to letter n above. This position is detailed in FORM 2900: LIST OF OTHER LIABILITIES DETAILS.

c. EQUITY

1) Capital
a) Paid-in Capital
This position is filled with the paid-in capital of the Guarantee Company in accordance with applicable regulations.

b) Advance Capital Deposits
This position is filled with the amount of capital deposited but still in the recording process from the Financial Services Authority.

2) Reserves
This position is filled with reserves formed in accordance with the articles of association and/or decisions of owners or the General Meeting of Shareholders, namely:

a) General Reserve
This position is filled with reserves formed from the allocation of net profit after tax which is used to cover losses arising from the implementation of the Guarantee Company's business activities.

b) Specific Reserve
This position is filled with the portion of profit after tax set aside for specific purposes.

c) Other Reserves
This position is filled with reserves that are not included in the general reserve and specific reserve in letters a and b, including reserves formed from the difference in the revaluation of fixed assets.

3) Grants
This position is filled with grants received by the Guarantee Company.

4) Retained Earnings/(Accumulated Losses)
This position is filled with the retained earnings/(accumulated losses) of the Guarantee Company at the beginning of the year.

5) Profit/(Loss) for the Current Year
This position is filled with the profit/(loss) of the Guarantee Company during the accounting period up to the reporting date.

6) Other Comprehensive Income
This position is filled with the profit/(loss) of other comprehensive income (OCI) by the Guarantee Company during the accounting period, from the beginning of the year to the reporting date. The value of this position must be the same as the Other Comprehensive Income position in FORM 1200: COMPREHENSIVE INCOME STATEMENT.

B. FORM 1200: COMPREHENSIVE INCOME STATEMENT

FORM 1200 (COMPREHENSIVE INCOME STATEMENT) FORMAT
FORM 1200 COMPREHENSIVE INCOME STATEMENT is prepared in the following format:

Position	Amount
a. Income
1) Guarantee Service Fee Income
a) Gross Guarantee Service Fee
b) Co-guarantee Guarantee Service Fee/Re-guarantee Guarantee Service Fee/Reinsurance Premium Expenses
c) Guarantee Commission Income
d) Guarantee Commission Expenses
Total Net Guarantee Service Fee Income
2) Operational Income
a) Interest Income
b) Investment Income Other Than Interest
c) Fair Value Increase of Securities
d) Gains on Sale of Financial Assets
e) Sale of Investments in Associates/Joint Ventures
f) Subrogation Income
g) Other Operational Income
Total Operational Income
3) Non-Operational Income
Total Income
b. Expenses
1) Claims
a) Claim Expenses
b) Decrease/Increase in Claim Reserves
Total Claim Expenses
2) Operational Expenses
a) Employee Expenses
b) Workforce Development and Training Expenses
c) General and Administrative Expenses
d) Depreciation and Amortization Expenses
e) Fair Value Decrease of Financial Assets
f) Fair Value Increase of Financial Liabilities
g) Losses on Sale of Financial Assets
h) Losses on Sale of Securities
i) Losses on Sale of Investments in Associates/Joint Ventures
j) Other Operational Expenses
Total Operational Expenses
3) Non-Operational Expenses
Total Expenses
c. Profit/(Loss) Before Tax
d. Tax Expenses
e. Profit/(Loss) After Tax
f. Other Comprehensive Income
g. Comprehensive Profit/(Loss)

EXPLANATION OF FORM 1200 (COMPREHENSIVE INCOME STATEMENT)
FORM 1200 COMPREHENSIVE INCOME STATEMENT contains the comprehensive income statement of the Guarantee Company, providing detailed explanations of income positions, expenses, profit/(loss) before tax, tax expenses, profit/(loss) after tax, comprehensive income, and comprehensive profit/(loss), as follows:

a. Income

1) Guarantee Service Fee Income
a) Gross Guarantee Service Fee
This position is filled with Guarantee Service Fee income obtained by the Guarantee Company from guarantee business activities, including Guarantee Service Fee that is the portion of co-guarantee partner companies, re-guarantee companies, or insurance companies. Guarantee Service Fee obtained is recognized as income based on the accrual basis which is allocated proportionally during the guarantee period.

b) Co-guarantee Guarantee Service Fee/Re-guarantee Guarantee Service Fee/Reinsurance Premium Expenses This position is filled with the portion of Gross Guarantee Service Fee that is paid out or is the portion of co-guarantee partner companies/re-guarantee companies/reinsurance companies. Co-guarantee Guarantee Service Fee/Re-guarantee Guarantee Service Fee/reinsurance premiums are recognized and recorded in the same period as the recognition period of the corresponding Guarantee Service Fee income.

c) Guarantee Commission Income
This position is filled with commission income received by the Guarantee Company in connection with guarantee activities.

d) Guarantee Commission Expense
This item is filled with the commission expenses received by the Guarantee Company in connection with guarantee activities.

Operating Income
a) Interest Income
This item is filled with interest income obtained by the Guarantee Company from fund placements, including in the form of deposits, bonds, Government Securities, and other securities. b) Investment Income Other Than Interest This item is filled with investment income obtained by the Guarantee Company other than interest income. c) Increase in Fair Value of Securities This item is filled with unrealized potential gains from securities measured at fair value through profit or loss, which is the positive difference between the fair value of financial assets on the reporting date and the fair value of those financial assets in the previous period. d) Gains on Sale of Financial Assets This item is filled with realizable gains from the sale of financial assets. e) Sale of Investments in Associates/Joint Ventures. This item is filled with realized gains from investments in associates or joint ventures. f) Subrogation Income This item is filled with income obtained from subrogation. g) Other Operating Income This item is filled with operating income obtained by the Guarantee Company other than operating income in items letter a through letter f above.
Non-Operating Income
This item is filled with all income/gains obtained other than the main activities of the Guarantee Company, including gains from the sale of fixed assets.

b. Expenses

Claims
a) Claim Expenses
This item is filled with the value of settled claims, which is the Guarantee Company's portion (self-retention). Claims are recognized as expenses when the claim submission has been approved by the Guarantee Company (accrual basis). b) Decrease/Increase in Claim Provisions This item is filled with the difference between the current period's claim provisions and the previous period's. In the event of a decrease in claim provisions, it will be recorded as a factor reducing claim expenses. Conversely, if there is an increase in claim provisions, it will be recorded as a factor increasing claim expenses.
Operating Expenses
a) Employee Expenses
This item is filled with basic salary, wages, allowances, honoraria, and other human resource expenses outside of salary, wages, allowances, and honoraria. b) Workforce Development and Training Expenses This item is filled with expenses incurred by the Guarantee Company for workforce development and training.

c) General and Administrative Expenses.
This item is filled with operational expenses that can be grouped into general and administrative expenses, including rental expenses and office operational expenses. d) Depreciation and Amortization Expenses. This item is filled with fixed asset depreciation expenses and intangible asset amortization expenses. e) Decrease in Fair Value of Financial Assets. This item is filled with unrealized potential losses from financial assets measured at fair value through profit or loss, which is the negative difference between the fair value of financial assets on the reporting date and the fair value of financial assets in the previous period. f) Increase in Fair Value of Financial Liabilities This item is filled with unrealized potential losses from financial liabilities measured at fair value through profit or loss, which is the positive difference between the fair value of financial liabilities on the reporting date and the fair value of those financial liabilities in the previous period. g) Losses on Sale of Financial Assets This item is filled with realized losses from the sale of financial assets. h) Losses on Sale of Securities This item is filled with realized losses from the sale of securities. i) Losses on Sale of Investments in Associates/Joint Ventures This item is filled with realized losses from investments in associates or joint ventures.

j) Other Operating Expenses
This item is filled with other operating expenses that do not fall into any of the items letter a through letter i above.

Non-Operating Expenses
This item is filled with all expenses/losses borne by the Guarantee Company for non-operational activities.

c. Profit/(Loss) Before Tax
This item is filled with the positive/negative difference of operating profit/(loss) plus/minus non-operating income/expenses. d. Tax Expenses This item is filled with deferred tax expenses related to the amount of deferred tax liabilities recognized for the current year period up to the monthly reporting date. e. Profit/(Loss) After Tax This item is filled with profit/(loss) after income tax for the current period. f. Other Comprehensive Income This item is filled with, among others:

Revaluation surplus of fixed assets;
Remeasurement of defined benefit employee benefits; and
Unrealized gains/(losses) from increases/decreases in investment value.
g. Comprehensive Profit (Loss)
This item is filled with the net profit (loss) after tax plus other comprehensive income.

C. FORM 1300 (CASH FLOW STATEMENT)

FORM 1300 (CASH FLOW STATEMENT) FORMAT
FORM 1300 CASH FLOW STATEMENT is prepared according to the following format:

Item	Current Month Before	Current Month After
a. Cash Flows from Operating Activities
1) Cash Inflows
a) IJP Income
b) Co-Guarantee Claim Receipts
c) Reinsurance/Guarantee Claim Receipts
d) Other Operational Receipts
e) Non-Operational Receipts
Total Cash Inflows from Operating Activities
2) Cash Outflows
a) Co-Guarantee IJP Payment / Reinsurance IJP / Reinsurance Premium
b) Claim Payments to Guarantee Recipients
c) Other Operational Expense Payments
d) Other Non-Operational Expense Payments
Total Cash Outflows from Operating Activities
3) Net Cash Flows from Operating Activities
b. Cash Flows from Investing Activities
1) Cash Inflows
a) Investment Result Receipts
b) Fixed Asset Sale Receipts
c) Investment Sale Result Receipts
Total Cash Inflows from Investing Activities
2) Cash Outflows
a) Permitted Investment Placements
b) Acquisition of Fixed Assets
Total Cash Outflows from Investing Activities
3) Net Cash Flows from Investing Activities
c. Cash Flows from Financing Activities
1) Cash Inflows
a) Capital Deposit Receipts
b) Mandatory Convertible Bond Issuance
c) Other Receipts
Total Cash Inflows from Financing Activities
2) Cash Outflows
a) Dividend Payments
b) Other Expenditures
Total Cash Outflows from Financing Activities
3) Net Cash Flows from Financing Activities
d. Cash Increase (Decrease)
e. Beginning Cash Balance
f. Ending Cash Balance

EXPLANATION OF FORM 1300 (CASH FLOW STATEMENT)
FORM 1300 CASH FLOW STATEMENT contains the cash flow statement of the Guarantee Company, providing detailed explanations of cash flow positions from operating activities, investing activities, financing activities, cash increase (decrease), beginning cash balance, and ending cash balance, with explanations as follows:

a. Cash Flows from Operating Activities

Cash Inflows
a) IJP Income
This item is filled with IJP income obtained by the Guarantee Company from guarantee business activities, including IJP which is the portion of co-guarantee partner companies/reinsurance guarantee companies/reinsurance companies. b) Co-Guarantee Claim Receipts This item is filled with claim receipts from co-guarantee partners, which is the portion of the Guarantee Company. c) Reinsurance/Guarantee Claim Receipts This item is filled with claim receipts from reinsurance partner companies, which is the portion of the Guarantee Company.

d) Other Operational Receipts
This item is filled with cash receipts from operational activities not included in items letter a through letter c above. e) Non-Operational Receipts This item is filled with cash receipts from non-operational activities.

Cash Outflows
a) Co-Guarantee IJP Payment / Reinsurance IJP / Reinsurance Premium Payment This item is filled with all cash expenditures for co-guarantee IJP payment / reinsurance IJP / reinsurance premium payment. b) Claim Payments to Guarantee Recipients This item is filled with all cash expenditures for claim payments to guarantee recipients. c) Other Operational Expense Payments This item is filled with all cash expenditures for operational activities not included in items letter a and letter b above. d) Non-Operational Expense Payments This item is filled with all cash expenditures from non-operational activities.
Net Cash Flows from Operating Activities
This item is filled with net cash obtained from or used for operating activities.

b. Cash Flows from Investing Activities

Cash Inflows
a) Investment Result Receipts
This item is filled with all investment result receipts conducted by the Guarantee Company, whether in the form of interest or other investment results.

b) Fixed Asset Sale Receipts
This item is filled with cash receipts for fixed asset sale transactions, including land and buildings. c) Investment Sale Result Receipts This item is filled with investment result receipts from the sale of investments.

Cash Outflows
a) Permitted Investment Placements
This item contains all cash expenditures used for investments, including fund placements in the form of bank deposits and the purchase of securities. b) Acquisition of Fixed Assets This item is filled with cash expenditures for fixed asset purchase transactions, including land and buildings.
Net Cash Flows from Investing Activities
This item is filled with net cash obtained from or used for investing activities.

c. Cash Flows from Financing Activities

Cash Inflows
a) Capital Deposit Receipts
This item is filled with capital deposits/additional capital receipts by the Guarantee Company from shareholders. b) Mandatory Convertible Bond Issuance This item is filled with fund receipts from the issuance of mandatory convertible bonds. c) Other Receipts This item is filled with cash receipts from financing activities not included in items letter a and letter b above.
Cash Outflows
a) Dividend Payments
This item is filled with dividend payments made by the Guarantee Company to the shareholders of the Guarantee Company. b) Other Expenditures This item is filled with the recording of all cash expenditures for other financing activities.
Net Cash Flows from Financing Activities
This item is filled with net cash obtained from or used for financing activities.

d. Cash Increase (Decrease)
This item is filled with the net increase or decrease in cash and cash equivalents up to the reporting date period. e. Beginning Cash Balance This item is filled with cash and cash equivalents at the beginning of the Guarantee Company's reporting fiscal year. f. Ending Cash Balance This item is filled with cash and cash equivalents at the beginning of the Guarantee Company's reporting fiscal year.

D. FORM 2100: INVESTMENT ASSET DETAIL LIST

FORM 2100 (INVESTMENT ASSET DETAIL LIST) FORMAT
FORM 2100: INVESTMENT ASSET DETAIL LIST is prepared according to the following format:

a. Deposits

Current Category
| No. | Counterparty Code | Issuer | Bill Number | Value | i. Bank Name | ii. Bank Branch | i. Interest Rate | ii. Interest Type | i. Start Date | ii. Maturity Date | iii. Tenor | ARO Description | CKPN i. Individual | ii. Collective | Net Amount |
| :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- |
| 1. | | | | | | | | | | | | | | | |
| 2. | | | | | | | | | | | | | | | |
| 3. | | | | | | | | | | | | | | | |
| ... | | | | | | | | | | | | | | | |
| Total | | | | | | | | | | | | | | | |
Non-Current Category
| No. | Counterparty Code | Issuer | Bill Number | Value | i. Bank Name | ii. Bank Branch | i. Interest Rate | ii. Interest Type | i. Start Date | ii. Maturity Date | iii. Tenor | ARO Description | CKPN i. Individual | ii. Collective | Net Amount |
| :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- |
| 1. | | | | | | | | | | | | | | | |
| 2. | | | | | | | | | | | | | | | |
| 3. | | | | | | | | | | | | | | | |
| ... | | | | | | | | | | | | | | | |
| Total | | | | | | | | | | | | | | | |

b. Securities

Current Category
| No. | Security Type | Security Name | Issuer Name | Investment Manager/Broker Name | Issuer Code | Rating | Rating Agency | Measurement Category | i. Issue Date | ii. Maturity Date | i. Interest/Coupon Rate | ii. Interest/Coupon Type | NAB or Share Price | UP or Share Nominal | CKPN i. Individual | ii. Collective | Net Amount |
| :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- |
| 1. | | | | | | | | | | | | | | | | | |
| 2. | | | | | | | | | | | | | | | | | |
| ... | | | | | | | | | | | | | | | | | |
| Total | | | | | | | | | | | | | | | | | |
Non-Current Category
| No. | Security Type | Security Name | Issuer Name | Investment Manager/Broker Name | Issuer Code | Rating | Rating Agency | Measurement Category | i. Issue Date | ii. Maturity Date | i. Interest/Coupon Rate | ii. Interest/Coupon Type | NAB or Share Price | UP or Share Nominal | CKPN i. Individual | ii. Collective | Net Amount |
| :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- |
| 1. | | | | | | | | | | | | | | | | | |
| 2. | | | | | | | | | | | | | | | | | |
| ... | | | | | | | | | | | | | | | | | |
| Total | | | | | | | | | | | | | | | | | |

c. Land and Buildings

Current Category
| No. | Type | Address | Legal Status | Acquisition Value | Market Value | CKPN i. Individual | ii. Collective | Net Amount |
| :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- |
| 1. | | | | | | | | |
| 2. | | | | | | | | |
| ... | | | | | | | | |
| Total | | | | | | | | |
Non-Current Category
| No. | Type | Address | Legal Status | Acquisition Value | Market Value | CKPN i. Individual | ii. Collective | Net Amount |
| :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- |
| 1. | | | | | | | | |
| 2. | | | | | | | | |
| ... | | | | | | | | |
| Total | | | | | | | | |

d. Direct Participation

Current Category
| No. | Investee Name | Participation Method | Participation Start Date | Ownership Percentage | Acquisition Value | Report Month | CKPN i. Individual | ii. Collective | Net Amount |
| :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- |
| 1. | | | | | | | | | |
| 2. | | | | | | | | | |
| ... | | | | | | | | | |
| Total | | | | | | | | | |
Non-Current Category
| No. | Investee Name | Participation Method | Participation Start Date | Ownership Percentage | Acquisition Value | Report Month | CKPN i. Individual | ii. Collective | Net Amount |
| :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- |
| 1. | | | | | | | | | |
| 2. | | | | | | | | | |
| ... | | | | | | | | | |
| Total | | | | | | | | | |

EXPLANATION OF FORM 2100 (INVESTMENT ASSET DETAIL LIST)
FORM 2100 INVESTMENT ASSET DETAIL LIST contains details of investment assets including deposits, securities, land and buildings, and direct participation, with explanations as follows:

a. Deposits

Current Category
Non-current category refers to deposits that are realized within a period of more than 12 (twelve) months after reporting by the Guarantee Company. a) No. This item is filled with the row sequence in the form. b) Counterparty Code This item is filled with the code from the issuer where the Guarantee Company places funds in the form of deposits as issued by Bank Indonesia. c) Issuer
i. Bank Name
This item is filled with the full name of the bank where the Guarantee Company places funds in the form of deposits.
ii. Bank Branch
This item is filled with the name of the branch of the bank where the Guarantee Company places funds in the form of deposits. d) Bill Number This item is filled with the bill number of the deposit. e) Value This item is filled with the deposit nominal for the monthly reporting period. f) Interest Rate This item is filled with the deposit interest rate at the bank. g) Tenor
i. Start
This item is filled with the date, month, and year of the start of fund placement in the form of deposits at the bank.
ii. Maturity
This item is filled with the date, month, and year of the deposit maturity at the bank.
iii. Tenor
This item is filled with the tenor of the deposit, calculated as a term of more than 1 (one) month at the bank. h) Automatic Roll Over (ARO) Description This item is filled with the description if the deposit at the bank is automatically extended (ARO). Filled with "Yes" or "No". i) Provision for Credit Losses (CKPN)
i. Individual
This item is filled with the CKPN formation method individually.
ii. Collective
This item is filled with the CKPN formation method collectively. j) Net Amount This item is filled with the deposit value after considering individual CKPN or collective CKPN for the monthly reporting period.
Non-Current Category
Non-current category refers to deposits that are realized within a period of more than 12 (twelve) months after reporting by the Guarantee Company. a) No. This item is filled with the row sequence in the form. b) Counterparty Code This item is filled with the code from the issuer where the Guarantee Company places funds in the form of deposits as issued by Bank Indonesia. c) Issuer
i. Bank Name
This item is filled with the full name of the bank where the Guarantee Company places funds in the form of deposits.
ii. Bank Branch
This item is filled with the name of the branch of the bank where the Guarantee Company places funds in the form of deposits. d) Bill Number This item is filled with the bill number of the deposit. e) Value This item is filled with the deposit nominal for the monthly reporting period. f) Interest Rate This item is filled with the deposit interest rate at the bank. g) Tenor
i. Start
This item is filled with the date, month, and year of the start of fund placement in the form of deposits at the bank.
ii. Maturity
This item is filled with the date, month, and year of the deposit maturity at the bank.
iii. Tenor
This item is filled with the tenor of the deposit, calculated as a term of more than 1 (one) month at the bank. h) ARO Description This item is filled with the description if the deposit at the bank is automatically extended (ARO). Filled with "Yes" or "No". i) CKPN
i. Individual
This item is filled with the CKPN formation method individually.
ii. Collective
This item is filled with the CKPN formation method collectively. j) Net Amount This item is filled with the deposit value after considering individual CKPN or collective CKPN for the monthly reporting period.

b. Securities

Current Category
Current category refers to securities that are realized, or intended to be sold or used, in the normal operating cycle, for trading purposes, or expects to be realized within a period of 12 (twelve) months after reporting by the Guarantee Company. a) No. This item is filled with the row sequence in the form. b) Security Type This item is filled with the type of security, namely:

Government Securities (including government bonds or Indonesian retail bonds or ORI, Treasury Bills or SPN, Sharia Government Securities or SBSN);
Commercial Paper (CP);
Medium Term Notes (MTN) or Sharia MTN;
Stocks;
Asset-Backed Securities;
Mutual Funds;
Bonds;
Sukuk; or
Other Securities.
c) Security Name
This item is filled with the name of the security. d) Issuer Name This item is filled with the name of the party that is the issuer of the security. e) Investment Manager/Broker Name This item is filled with the name of the party that is the Investment Manager or broker of the security. f) Issuer Code This item is filled with the issuer where the Guarantee Company places funds in the form of securities as issued by the Stock Exchange or Exchange Authority. g) Rating This item is filled with the rating of the security issued by a rating agency. h) Rating Agency This item is filled with the name of the internationally recognized rating agency. i) Measurement Category This item is filled with the financial asset measurement category in accordance with Financial Accounting Standards Statement (PSAK) 71, including fair value to profit and loss (FFVTPL), fair value to other comprehensive income (FVOCI), and amortized cost. j) Tenor:
i. Issue Date
This item is filled with the date, month, and year of the start of fund placement in the form of securities.
ii. Maturity Date
This item is filled with the date, month, and year of the security maturity. k) Interest Rate or Coupon
i. Interest Rate or Coupon Level
This item is filled with the interest rate of the security.
ii. Interest Rate or Coupon Type
This item is filled with one of the interest rate types, namely fixed or variable. l) Net Asset Value (NAV) or Share Price This item is filled with the net asset value for investments in the form of mutual funds or the price per share for investments in the form of stocks. m) Unit Participation (UP) or Share This item is filled with the unit participation value for investments in the form of mutual funds or the number of participations per share for investments in the form of stocks. n) Nominal
i. Previous Month
This item is filled with the amount in the previous reporting period.
ii. Report Month
This item is filled with the amount in the monthly reporting period. o) CKPN
i. Individual
This item is filled with the CKPN formation method individually.
ii. Collective
This item is filled with the CKPN formation method collectively. p) Net Amount This item is filled with the security value after considering individual CKPN or collective CKPN for the monthly reporting period.

Non-Current Category
Non-current category refers to securities that are realized, or intended to be sold or used, in the normal operating cycle, for trading purposes, or expects to be realized within a period of more than 12 (twelve) months after reporting by the Guarantee Company. a) No. This item is filled with the row sequence in the form. b) Security Type This item is filled with the type of security, namely:

Government Securities (including government bonds or Indonesian retail bonds or ORI, Treasury Bills or SPN, Sharia Government Securities or SBSN);
Commercial Paper (CP);
MTN or Sharia MTN;
Stocks;
Asset-Backed Securities;
Mutual Funds;
Bonds;
Sukuk; or
Other Securities
c) Security Name
This item is filled with the name of the security. d) Issuer Name This item is filled with the name of the party that is the issuer of the security. e) Investment Manager/Broker Name This item is filled with the name of the party that is the Investment Manager or broker of the security. f) Issuer Code This item is filled with the issuer where the Guarantee Company places funds in the form of securities as issued by the Stock Exchange or Exchange Authority. g) Rating This item is filled with the rating of the security issued by a rating agency. h) Rating Agency This item is filled with the name of the internationally recognized rating agency. i) Measurement Category This item is filled with the financial asset measurement category in accordance with PSAK 71, including fair value to profit and loss (FFVTPL), fair value to other comprehensive income (FVOCI), and amortized cost. j) Tenor
i. Issue Date
This item is filled with the date, month, and year of the start of fund placement in the form of securities.
ii. Maturity Date
This item is filled with the date, month, and year of the security maturity. k) Interest Rate or Coupon
i. Interest Rate or Coupon Level
This item is filled with the interest rate of the security.
ii. Interest Rate or Coupon Type
This item is filled with one of the interest rate types, namely fixed or variable. l) NAV or Share Price This item is filled with the net asset value for investments in the form of mutual funds or the price per share for investments in the form of stocks. m) UP or Share This item is filled with the unit participation value for investments in the form of mutual funds or the number of participations per share for investments in the form of stocks. n) Nominal
i. Previous Month
This item is filled with the amount in the previous reporting period.
ii. Report Month
This item is filled with the amount in the monthly reporting period. o) CKPN
i. Individual
This item is filled with the CKPN formation method individually.
ii. Collective
This item is filled with the CKPN formation method collectively. p) Net Amount This item is filled with the security value after considering individual CKPN

or Collective CKPN during the reporting month.
c. Land and Buildings

Current Category
The non-current category refers to land and buildings that are realized or intended to be sold in the normal operating cycle within a period of 12 (twelve) months after reporting by the Guarantee Company. a) No. This field is filled with the row sequence in the form. b) Type This field is filled with either "Land" or "Building". c) Address This field is filled with the address of the land or building. d) Legal Status This field is filled with the land or building ownership certificate, including among others: Certificate of Ownership Rights (SHM), Certificate of Right to Manage Land (HGU), Certificate of Right to Use, and Certificate of Right to Build (SHGB). e) Acquisition Value This field is filled with the acquisition value of the land or building. f) Market Value This field is filled with the market value of the land or building during the reporting period. g) CKPN
i. Individual
This field is filled with the method of forming CKPN individually.
ii. Collective
This field is filled with the method of forming CKPN collectively.

h) Net Amount
This field is filled with the value of securities after considering individual or collective CKPN during the reporting month.
2) Non-Current Category
The non-current category refers to land and buildings that are realized or intended to be sold in the normal operating cycle within a period of more than 12 (twelve) months after reporting by the Guarantee Company. a) No. This field is filled with the row sequence in the form. b) Type This field is filled with either "Land" or "Building". c) Address This field is filled with the address of the land or building. d) Legal Status This field is filled with the land or building ownership certificate, including among others: Certificate of Ownership Rights (SHM), Certificate of Right to Manage Land (HGU), Certificate of Right to Use, and Certificate of Right to Build (SHGB). e) Acquisition Value This field is filled with the acquisition value of the land or building. f) Market Value This field is filled with the market value of the land or building during the reporting period. g) CKPN
i. Individual
This field is filled with the method of forming CKPN individually.
ii. Collective
This field is filled with the method of forming CKPN collectively. h) Net Amount This field is filled with the value of securities after considering individual or collective CKPN during the reporting month. d. Direct Investments

Current Category
The current category refers to direct investments that are realized within a period of 12 (twelve) months after reporting by the Guarantee Company. a) No. This field is filled with the row sequence in the form. b) Investee Name This field is filled with the name of the investee company where the Guarantee Company makes the direct investment. c) Investment Method This field is filled with one of the investment methods, namely the cost method or the equity method. d) Investment Start Date This field is filled with the date, month, and year the investment in the investee company becomes effective. e) Ownership Percentage This field is filled with the percentage of investment in the investee company. f) Acquisition Value This field is filled with the acquisition value at the time of investment. g) Reporting Month Amount This field is filled with the amount during the monthly reporting period.

h) CKPN
i. Individual
This field is filled with the method of forming CKPN individually.
ii. Collective
This field is filled with the method of forming CKPN collectively. i) Net Amount This field is filled with the value of securities after considering individual or collective CKPN during the reporting month.
2) Non-Current Category
The non-current category refers to direct investments that are realized within a period of more than 12 (twelve) months after reporting by the Guarantee Company. a) No. This field is filled with the row sequence in the form. b) Investee Name This field is filled with the name of the investee company where the Guarantee Company makes the direct investment. c) Investment Method This field is filled with one of the investment methods, namely the cost method or the equity method. d) Investment Start Date This field is filled with the date, month, and year the investment in the investee company becomes effective. e) Ownership Percentage This field is filled with the percentage of investment in the investee company. f) Acquisition Value This field is filled with the acquisition value at the time of investment. g) Reporting Month Amount This field is filled with the amount during the monthly reporting period. h) CKPN
i. Individual
This field is filled with the method of forming CKPN individually.
ii. Collective
This field is filled with the method of forming CKPN collectively. i) Net Amount This field is filled with the value of securities after considering individual or collective CKPN during the reporting month.

E. FORM 2200: DETAIL LIST OF IJP RECEIVABLES

FORMAT OF FORM 2200 (DETAIL LIST OF IJP RECEIVABLES)
FORM 2200 DETAIL LIST OF IJP RECEIVABLES is prepared according to the following format:

No. Name of Guarantor
Guarantee Type
Guarantee Product
Guaranteed Amount
(Unit)
Credit/Project Value
(Rp)
1.
2.
3. etc.
7) 8) 9) 10)
Guarantee Value
(Rp)
Outstanding
Guarantee (Rp)
IJP Receivable Value
(Rp)
CKPN (Rp)
2. EXPLANATION OF FORM 2200 (DETAIL LIST OF IJP RECEIVABLES)
FORM 2200 DETAIL LIST OF IJP RECEIVABLES contains details of IJP receivables from the Indonesian Government, both central and regional, related to guarantee business activities that are government assignment programs, such as the People's Business Credit (KUR) guarantee program. Sharia Guarantee Companies and/or Sharia Business Units that receive assignments from the government must prove this with evidence of assignment. The explanation is as follows:

No.
This field is filled with the row sequence in the form.
Name of Guarantor
This field is filled according to the name of the financial institution or non-financial institution that has provided credit, financing, or service contracts to the guaranteed party.
Type of Guarantee
This field is filled with the type of guarantee classified as follows:
a) Productive Credit Guarantee – MSME; b) Productive Credit Guarantee – Non-MSME; c) Other Guarantees – Guarantee on debt securities; d) Other Guarantees – Installment purchase guarantee; e) Other Guarantees – Trade transaction guarantee; f) Other Guarantees – Goods and/or services procurement guarantee (surety bond); g) Other Guarantees – Bank guarantee guarantee (counter bank guarantee); h) Other Guarantees – Domestic documentary credit guarantee; i) Other Guarantees – Letter of credit guarantee; j) Other Guarantees – Customs guarantee (customs bond); k) Other Guarantees – Excise guarantee; l) Other Guarantees – Provision of management consulting services related to guarantee business activities; m) Other Guarantees – Other business activities after obtaining approval from the Financial Services Authority; and n) Non-Productive Guarantee.
Guarantee Product
This field is filled with the name of the guarantee product owned by the guarantee company, for example: Surety Bond Advance Payment Guarantee, KUKPEDES Guarantee (Small Rural Business Credit), All-Purpose Credit Guarantee, Multi-Purpose Credit Guarantee, and others.
Guaranteed Amount (Unit)
This field is filled with the guaranteed amount guaranteed by the Guarantee Company.
Credit/Project Value
This field is filled with the credit amount or project value of the guaranteed party.
Guarantee Value
This field is filled with the guarantee coverage value according to the guarantee certificate.
Outstanding Guarantee
This field is filled with the outstanding guarantee value borne by the Guarantee Company.
IJP Receivable Value
This field is filled with IJP receivables from the Indonesian Government, both central and regional, related to guarantee business activities that are government assignment programs, such as the KUR guarantee program.
CKPN
This field is filled with the CKPN value according to Financial Accounting Standards.

F. FORM 2300: DETAIL LIST OF CO-GUARANTEE AND REINSURANCE/GUARANTEE AGAIN RECEIVABLES

FORMAT OF FORM 2300 (DETAIL LIST OF CO-GUARANTEE AND REINSURANCE/GUARANTEE AGAIN RECEIVABLES)
FORM 2300: DETAIL LIST OF CO-GUARANTEE AND REINSURANCE/GUARANTEE AGAIN RECEIVABLES is prepared according to the following format:

No. Name
Guarantee
Certificate
Number
Guarantee
Certificate
Date
Type of
Guarantee
Product
Guarantee
Credit/Project
Value
Guarantee
Value
Guarantee
Value
Partner
Portion
1.
2.
3. etc.
10) 11) 12) 13) 14) 15) 16)
Partner
Name
Scheme
Claim
Amount
Claim
Date
Claim
Receivable
Number of
Days
Overdue
CKPN
2. EXPLANATION OF FORM 2300 (DETAIL LIST OF CO-GUARANTEE AND REINSURANCE/GUARANTEE AGAIN RECEIVABLES)
FORM 2300 DETAIL LIST OF CO-GUARANTEE AND REINSURANCE/GUARANTEE AGAIN RECEIVABLES contains details of IJP receivables from the Indonesian Government related to the People's Business Credit (KUR) guarantee program and/or to the guaranteed party related to guarantee business activities, with the explanation as follows:

No.
This field is filled with the row sequence in the form.
Name
This field is filled with the name of the individual guaranteed party.
Guarantee Certificate Number
This field is filled with the guarantee certificate number underlying the guarantee agreement.
Guarantee Certificate Date
This field is filled with the date of the guarantee certificate underlying the guarantee agreement.
Type of Guarantee
This field is filled with the type of guarantee classified as follows:
a) Productive Credit Guarantee – MSME; b) Productive Credit Guarantee – Non-MSME; c) Other Guarantees – Guarantee on debt securities; d) Other Guarantees – Installment purchase guarantee; e) Other Guarantees – Trade transaction guarantee; f) Other Guarantees – Goods and/or services procurement guarantee (surety bond); g) Other Guarantees – Bank guarantee guarantee (counter bank guarantee); h) Other Guarantees – Domestic documentary credit guarantee; i) Other Guarantees – Letter of credit guarantee; j) Other Guarantees – Customs guarantee (customs bond); k) Other Guarantees – Excise guarantee; l) Other Guarantees – Provision of management consulting services related to guarantee business activities;

m) Other Guarantees – Other business activities after obtaining approval from the Financial Services Authority; and n) Non-Productive Guarantee.
6) Guarantee Product
This field is filled with the name of the guarantee product owned by the guarantee company, for example: Surety Bond Advance Payment Guarantee, KUKPEDES Guarantee, All-Purpose Credit Guarantee, Multi-Purpose Credit Guarantee, and others.
7) Credit/Project Value
This field is filled with the value of the guaranteed credit or project.
8) Guarantee Value
This field is filled with the guarantee value provided by the Guarantee Company.
9) Guarantee Value Partner Portion
This field is filled with the guarantee value that is reinsured or guaranteed again.
10) Partner Name
This field is filled with the name of the co-guarantee/reinsurance/guarantee again partner.
11) Scheme
This field is filled with the guarantee scheme, namely co-guarantee or reinsurance/guarantee again.
12) Claim Amount
This field is filled with the claim value approved to be paid by the guarantee company to the guarantor.
13) Claim Date
This field is filled with the date the claim was approved by the guarantee company.
14) Claim Receivable
This field is filled with the claim amount not yet paid by the co-guarantee/reinsurance/guarantee again partner to the Guarantee Company.

Number of Days Overdue
This field is filled with the number of days of overdue claim payments to the leader with the co-guarantee guarantee mechanism.
CKPN
This field is filled with the CKPN value according to applicable financial accounting standards.

G. FORM 2400: DETAIL LIST OF OTHER ASSETS

FORMAT OF FORM 2400 (DETAIL LIST OF OTHER ASSETS)
FORM 2400: DETAIL LIST OF OTHER ASSETS is prepared according to the following format:

No. Description Current Assets
(Rp)
Non-Current
Assets (Rp)
1.
2.
3.
TOTAL
2. EXPLANATION OF FORM 2400 (DETAIL LIST OF OTHER ASSETS)
FORM 2400 DETAIL LIST OF OTHER ASSETS contains details of other assets that cannot be classified into the Asset accounts on the Statement of Financial Position, with the explanation as follows:

No.
This field is filled with the row sequence in the form.
Description
This field is filled with the components forming other assets. Example: vehicles, land, and so on.
Current Assets (Rp)
This field is filled with the total component forming current assets calculated net.
Non-Current Assets (Rp)
This field is filled with the total component forming non-current assets calculated net.

H. FORM 2500: DETAIL LIST OF FIXED ASSETS – NET

FORMAT OF FORM 2500 (DETAIL LIST OF FIXED ASSETS – NET)
FORM 2500: DETAIL LIST OF FIXED ASSETS – NET is prepared according to the following format:

No. Description Nominal (Rp)
2. EXPLANATION OF FORM 2500 (DETAIL LIST OF FIXED ASSETS – NET)
FORM 2500 DETAIL LIST OF FIXED ASSETS – NET contains details of tangible assets owned by the Guarantee Company and used in operational activities according to applicable financial accounting standards, with the explanation as follows:

No.
This field is filled with the row sequence in the form.
Description
This field is filled with the components forming fixed assets. Example: vehicles, land, right-of-use lease assets, and so on.
Nominal (Rp)
This field is filled with the total component forming fixed assets calculated net.

I. FORM 2600: DETAIL LIST OF COMMISSION PAYABLES

FORMAT OF FORM 2600 (DETAIL LIST OF COMMISSION PAYABLES)
FORM 2600: DETAIL LIST OF COMMISSION PAYABLES is prepared according to the following format:

No. Name of Guarantor
Guarantee Type Guarantee Product Agent Name
1.
2.
3. etc.
6) 7)
Commission Payable (Rp) Number of Days
Overdue
(Unit)
2. EXPLANATION OF FORM 2600 (DETAIL LIST OF COMMISSION PAYABLES)
FORM 2600 DETAIL LIST OF COMMISSION PAYABLES contains details of commission payables to other parties related to the closing of guarantees, with the explanation as follows:

No.
This field is filled with the row sequence in the form.
Name of Guarantor
This field is filled according to the name of the financial institution or non-financial institution that has provided credit, financing, or service contracts to the guaranteed party.
Type of Guarantee
This field is filled with the type of guarantee classified as follows:

a) Productive Credit Guarantee – MSME; b) Productive Credit Guarantee – Non-MSME; c) Other Guarantees – Guarantee on debt securities; d) Other Guarantees – Installment purchase guarantee; e) Other Guarantees – Trade transaction guarantee; f) Other Guarantees – Goods and/or services procurement guarantee (surety bond); g) Other Guarantees – Bank guarantee guarantee (counter bank guarantee); h) Other Guarantees – Domestic documentary credit guarantee; i) Other Guarantees – Letter of credit guarantee; j) Other Guarantees – Customs guarantee (customs bond); k) Other Guarantees – Excise guarantee; l) Other Guarantees – Provision of management consulting services related to guarantee business activities; m) Other Guarantees – Other business activities after obtaining approval from the Financial Services Authority; and n) Non-Productive Guarantee.
4) Guarantee Product
This field is filled with the name of the guarantee product owned by the guarantee company, for example: Surety Bond Advance Payment Guarantee, KUKPEDES Guarantee, All-Purpose Credit Guarantee, Multi-Purpose Credit Guarantee, and others.
5) Agent Name
This field is filled with the name of the broker or guarantee agent.
6) Commission Payable
This field is filled with the amount of commission payable to other parties related to the closing of guarantees.
7) Number of Days Overdue

This field is filled with the number of days of overdue commission payments up to the reporting period.

J. FORM 2700: DETAIL LIST OF CO-GUARANTEE CLAIM PAYABLES

FORMAT OF FORM 2700 (DETAIL LIST OF CO-GUARANTEE CLAIM PAYABLES)
FORM 2700: DETAIL LIST OF CO-GUARANTEE CLAIM PAYABLES is prepared according to the following format:

No. Name of Guaranteed Party Type
Guarantee
Product
Guarantee
Partner Company
Name
1.
2.
3. etc.
6) 7)
Claim Payable (Rp) Number of Days
Overdue
2. EXPLANATION OF FORM 2700 (DETAIL LIST OF CO-GUARANTEE CLAIM PAYABLES)
FORM 2700 DETAIL LIST OF CO-GUARANTEE CLAIM PAYABLES contains details of liabilities in co-guarantee guarantee business together with co-guarantee partners, with the explanation as follows:

No.
This field is filled with the row sequence in the form.
Name of Guaranteed Party
This field is filled with the name of the individual guaranteed party.
Type of Guarantee
This field is filled with the type of guarantee classified as follows:
a) Productive Credit Guarantee – MSME;

b) Productive Credit Guarantee – Non-MSME; c) Other Guarantees – Guarantee on debt securities; d) Other Guarantees – Installment purchase guarantee; e) Other Guarantees – Trade transaction guarantee; f) Other Guarantees – Goods and/or services procurement guarantee (surety bond); g) Other Guarantees – Bank guarantee guarantee (counter bank guarantee); h) Other Guarantees – Domestic documentary credit guarantee; i) Other Guarantees – Letter of credit guarantee; j) Other Guarantees – Customs guarantee (customs bond); k) Other Guarantees – Excise guarantee; l) Other Guarantees – Provision of management consulting services related to guarantee business activities; m) Other Guarantees – Other business activities after obtaining approval from the Financial Services Authority; and n) Non-Productive Guarantee.
4) Guarantee Product
This field is filled with the name of the guarantee product owned by the guarantee company, for example: Surety Bond Advance Payment Guarantee, KUKPEDES Guarantee, All-Purpose Credit Guarantee, Multi-Purpose Credit Guarantee, and others.
5) Partner Company Name
This field is filled with the name of the partner company of the Guarantee Company.
6) Claim Payable
This field is filled with the claim amount not yet paid to the partner company.

Number of Days Overdue
This field is filled with the number of days of overdue claim payments to the leader in relation to the co-guarantee guarantee mechanism. K. FORM 2800: DETAIL LIST OF IJP PAYABLES FOR CO-GUARANTEE AND REINSURANCE/GUARANTEE AGAIN

FORMAT OF FORM 2800 (DETAIL LIST OF IJP PAYABLES FOR CO-GUARANTEE
AND REINSURANCE/GUARANTEE AGAIN)
FORM 2800: DETAIL LIST OF IJP PAYABLES FOR CO-GUARANTEE AND REINSURANCE/GUARANTEE AGAIN is prepared according to the following format:

No. Scheme Name National Identity
Number
(NIK)/Taxpayer
Identification Number
(TP)
Gender
Guarantee
Certificate
Number
Guarantee
Certificate
Date
1.
2.
3. etc.
8) 9) 10) 11) 12)
Type of
Guarantor
Name of
Guarantor
Type
Guarantee
Product
Guarantee
Guaranteed
Location a. Regency/City b. Province
13) 14) 15) 16) 17) 18)
Economic Sector Credit/Project
Value
Guarantee
Value
Co-Guarantee/
Reinsurance Value
Outstanding
Guarantee
Own Retention
Date
Start
Guarantee

End Date of Guarantee Number of Days
IJP Debt
IJP Value IJP Payable CKPN
2. EXPLANATION OF FORM 2800 (DETAIL LIST OF IJP PAYABLES FOR CO-GUARANTEE
AND REINSURANCE/GUARANTEE AGAIN)
FORM 2800 DETAIL LIST OF IJP PAYABLES FOR CO-GUARANTEE AND REINSURANCE/GUARANTEE AGAIN contains details of liabilities that the Guarantee Company must pay to transfer claim risks, with the explanation as follows:

No.
This field is filled with the row sequence in the form.
Scheme
This field is filled with the guarantee scheme, namely co-guarantee or reinsurance/guarantee again.
Name
This field is filled with the name of the individual guaranteed party.
National Identity Number (NIK)/Taxpayer Identification Number (NPWP)
This field is filled with the NIK of the guaranteed party and the NPWP of the guaranteed party that is a legal entity.
Gender
This field is filled with the gender of the guaranteed party. Fill "L" for male guaranteed parties and "P" for female guaranteed parties.
Guarantee Certificate Number
This field is filled with the guarantee certificate number underlying the guarantee agreement.
Guarantee Certificate Date

This field is filled with the date of the guarantee certificate underlying the guarantee agreement.
8) Type of Guarantor
This field is filled with "Bank", "Non-Bank Financial Institution", or "Surety".
9) Name of Guarantor
This field is filled according to the name of the financial institution or non-financial institution that has provided credit, financing, or service contracts to the guaranteed party.
10) Type of Guarantee
This field is filled with the type of guarantee classified as follows:
a) Productive Credit Guarantee – MSME; b) Productive Credit Guarantee – Non-MSME; c) Other Guarantees – Guarantee on debt securities; d) Other Guarantees – Installment purchase guarantee; e) Other Guarantees – Trade transaction guarantee; f) Other Guarantees – Goods and/or services procurement guarantee (surety bond); g) Other Guarantees – Bank guarantee guarantee (counter bank guarantee); h) Other Guarantees – Domestic documentary credit guarantee; i) Other Guarantees – Letter of credit guarantee; j) Other Guarantees – Customs guarantee (customs bond); k) Other Guarantees – Excise guarantee; l) Other Guarantees – Provision of management consulting services related to guarantee business activities; m) Other Guarantees – Other business activities after obtaining approval from the Financial Services Authority; and

n) Non-Productive Guarantee.
11) Guarantee Product
This field is filled with the name of the guarantee product owned by the guarantee company, for example: Surety Bond Advance Payment Guarantee, KUKPEDES Guarantee, All-Purpose Credit Guarantee, Multi-Purpose Credit Guarantee, and others.
12) Guaranteed Location
a. Regency/City
This field is filled with the regency/city of the guaranteed party's domicile. b. Province This field is filled with the province of the guaranteed party's domicile.
13) Economic Sector
This field is filled with the sector of the guaranteed party based on classification in the Central Bureau of Statistics Regulation regarding the standard classification of Indonesian business fields.
14) Credit/Project Value
This field is filled with the value of the guaranteed credit or project.
15) Guarantee Value
This field is filled with the guarantee value provided by the Guarantee Company.
16) Co-Guarantee/Reinsurance Value
This field is filled with the guarantee value that is reinsured or guaranteed again.
17) Outstanding Guarantee Own Retention
This field is filled with the outstanding guarantee value borne by the Guarantee Company.
18) Start Date of Guarantee
This field is filled with the start date of the guarantee according to the guarantee certificate.
19) End Date of Guarantee
This field is filled with the end date of the guarantee according to the guarantee certificate.

Number of Days IJP Debt
This field is filled with the number of days of unpaid IJP debt.
IJP Value
This field is filled with the value of the guarantee service remuneration to be provided by the Guarantee Company related to guarantee business activities.
IJP Payable
This field is filled with the co-guarantee or reinsurance/guarantee again IJP debt to be paid by the Guarantee Company to the reinsurance/guarantee again partner.
CKPN
This field is filled with the CKPN value according to applicable financial accounting standards.

L. FORM 2900: LIST OF OTHER LIABILITIES DETAILS

FORM 2900 FORMAT (LIST OF OTHER LIABILITIES DETAILS)
FORM 2900: LIST OF OTHER LIABILITIES DETAILS is prepared in the following format:

No. Description Current Liabilities (Rp)
Non-Current Liabilities (Rp)
1.
2.
3. etc.
Total
2. FORM 2900 EXPLANATION (LIST OF OTHER LIABILITIES DETAILS)
FORM 2900 LIST OF OTHER LIABILITIES DETAILS contains details of other liabilities that cannot be classified into the Liability accounts in the Statement of Financial Position, with the following explanations:

No.
This position is filled with the row sequence in the form.
Description
This position is filled with the components forming other liabilities.
Current Liabilities (Rp)
This position is filled with the net amount of components forming current liabilities.
Non-Current Liabilities (Rp)
This position is filled with the net amount of components forming non-current liabilities.

M. FORM 3000: LIST OF MANDATORY CONVERSION BOND DETAILS

FORM 3000 FORMAT (LIST OF MANDATORY CONVERSION BOND DETAILS)
FORM 3000 LIST OF MANDATORY CONVERSION BOND DETAILS is prepared in the following format:

No.
Bond Name
Nominal
Premium/
Discount
Interest
Rate
Duration i.
Start ii.
Maturity iii.
Tenor
1.
2.
3. etc.
Total
2. FORM 3000 EXPLANATION (LIST OF MANDATORY CONVERSION BOND DETAILS)
FORM 3000 LIST OF MANDATORY CONVERSION BOND DETAILS contains details of bonds issued by the Guarantee Company that are required to be converted into shares based on an agreement between the Guarantee Company and the bondholders, with the following explanations:

No.
This position is filled with the row sequence in the form.
Bond Name
This position is filled with the name of the mandatory conversion bond.
Nominal
This position is filled with the investment amount.
Premium/Discount
This position is filled with the discount or interest to be paid by the Guarantee Company.
Interest Rate
This position is filled with the bond interest rate.
Duration
i. Start
This position is filled with the date, month, and year of fund placement in the form of bonds.

ii. Maturity
This position is filled with the date, month, and year of bond maturity.
iii. Tenor
This position is filled with the bond duration.

N. FORM 3100: LIST OF GUARANTEE DETAILS

FORM 3100 FORMAT (LIST OF GUARANTEE DETAILS)
FORM 3100 LIST OF GUARANTEE DETAILS is prepared in the following format:

No. Guarantee
Certificate No.
Date
Guarantee
Certificate
Name
Guaranteed
NIK Economic
Sector
Type of Guarantee
1.
2.
3. etc.
8) 9) 10) 11) 12) 13) 14)
Guarantee
Product
Name
Guarantee
Recipient
Date
Start
Guarantee
Date
End
Guarantee
Credit/Facility
Value
Guarantee
Value
IJP Value
15) 16) 17) 18) 19)
IJP Value
Guarantee
Company Portion
IJP Value
Reinsurance/
Reinsurance
Premium
Acquisition
Cost
Guarantee
Value
Self-Insured
Guarantee Value
Reinsurance
Partner Portion
2. FORM 3100 EXPLANATION (LIST OF GUARANTEE DETAILS)
FORM 3100 LIST OF GUARANTEE DETAILS contains details of guarantees that are still outstanding during the reporting period (outstanding guarantees), with the following explanations:

No.
This position is filled with the sequential number in the form row.
Guarantee Certificate Number
This position is filled with the guarantee certificate number underlying the guarantee agreement.
Guarantee Certificate Date
This position is filled with the guarantee certificate date underlying the guarantee agreement.
Name of Guaranteed
This position is filled with the individual name of the guaranteed party.
NIK/NPWP
This position is filled with the NIK of the guaranteed party and the NPWP of the guaranteed party that is a legal entity.
Economic Sector
This position is filled with the sector of the guaranteed party based on the classification in the Central Bureau of Statistics Regulation regarding the standard classification of Indonesian business fields.
Type of Guarantee
This position is filled with the type of guarantee classified as follows:
a) Productive Credit Guarantee – SME Credit Guarantee; b) Productive Credit Guarantee – Non-SME Credit Guarantee; c) Other Guarantees – Guarantee on debt instruments; d) Other Guarantees – Installment purchase guarantee; e) Other Guarantees – Trade transaction guarantee; f) Other Guarantees – Procurement of goods and/or services guarantee (surety bond); g) Other Guarantees – Bank guarantee guarantee (counter bank guarantee); h) Other Guarantees – Domestic documentary letter of credit guarantee; i) Other Guarantees – Letter of credit guarantee; j) Other Guarantees – Customs bond guarantee; k) Other Guarantees – Excise guarantee; l) Other Guarantees – Provision of management consulting services related to guarantee business activities; m) Other Guarantees – Other business activities after obtaining approval from the Financial Services Authority; and n) Non-Productive Guarantee.
Guarantee Product
This position is filled with the name of the guarantee product owned by the guarantee company, for example, Surety Bond Advance Payment Guarantee, KUKPEDES Guarantee, All-Purpose Credit Guarantee, Multi-Use Credit Guarantee, and others.
Name of Guarantee Recipient
This position is filled with the name of the financial institution or non-financial institution that has provided credit, financing, or service contracts to the guaranteed party.
Guarantee Start Date
This position is filled with the start date of the guarantee according to the guarantee certificate.
Guarantee End Date
This position is filled with the end date of the guarantee according to the guarantee certificate.
Credit/Facility Value
This position is filled with the credit amount received by the guaranteed party from the credit-disbursing financial institution in connection with credit guarantee, or filled with the facility amount received by the guaranteed party in connection with non-credit guarantee.
Guarantee Value
This position is filled with the agreed guarantee value to be guaranteed based on the credit/facility value of the guaranteed party as stated in the guarantee certificate.
IJP Value
This position is filled with the guarantee service remuneration value received by the Guarantee Company as stated in the guarantee certificate.
IJP Value Guarantee Company Portion
This position is filled with the guarantee service remuneration value stated in the guarantee certificate that is the Guarantee Company's portion, excluding guarantee service remuneration that is the portion of the reinsurance/re-guarantee partner.
IJP Value Reinsurance/Reinsurance Premium
This position is filled with the portion of the guarantee service remuneration stated in the guarantee certificate that is the portion of the reinsurance/re-guarantee partner company.
Acquisition Cost
This position is filled with costs paid by the Guarantee Company in the context of business acquisition. Examples: commissions to guarantee agents and fee-based income to guarantee recipients.
Self-Insured Guarantee Value
This position is filled with the outstanding guarantee value insured (self-retention) by the Guarantee Company.
Reinsurance/Re-guarantee Partner Portion Guarantee Value
This position is filled with the outstanding guarantee value insured by the Reinsurance/Re-guarantee Partner.

O. FORM 3200: LIST OF GUARANTEE CLAIM REPORT PER GUARANTEED LOCATION

FORM 3200 FORMAT (LIST OF GUARANTEE CLAIM REPORT PER GUARANTEED LOCATION)
FORM 3200 LIST OF GUARANTEE CLAIM REPORT PER GUARANTEED LOCATION is prepared in the following format:
a. Credit Guarantee

No. Guaranteed Location (Province)
Productive Credit Guarantee –
SME Credit Guarantee (Non
KUR) a) Number
Guaranteed
(Unit) b) Guarantee
Value (Rp) c) Claim
Value (Rp)
4) 5)
Productive Credit Guarantee –
Micro Business Credit Guarantee
Non-SME
Non-Productive Credit Guarantee a) Number
Guaranteed
(Unit) b) Guarantee
Value (Rp) c) Claim
Value (Rp) a) Number
Guaranteed
(Unit) b) Guarantee
Value (Rp) c) Claim
Value (Rp)
6) 7)
KUR Guarantee -
Micro
KUR Guarantee -
Non-Micro a) Number
Guaranteed
(Unit) b) Guarantee
Value (Rp) c) Claim
Value (Rp) a) Number
Guaranteed
(Unit) b) Guarantee
Value (Rp) c) Claim
Value (Rp)
8)
Total a) Number
Guaranteed
(Unit) b) Guarantee
Value (Rp) c) Claim
Value (Rp)

b. Other Guarantees

2) 3)
No.
Location
Guaranteed
(Province)
Guarantee on Debt Instruments a) Number
Guaranteed
(Unit) b) Guarantee
Value (Rp) c) Claim Value (Rp)

Guarantee for Purchase of Goods in Installments Trade Transaction Guarantee a) Number Guaranteed (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp) a) Number Guaranteed (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp)
6) 7)
Procurement of goods and/or Services (Surety Bond) Bank Guarantee Guarantee (Counter Bank Guarantee) a) Number Guaranteed (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp) a) Number Guaranteed (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp)
8) 9)
Domestic Documentary Letter of Credit Guarantee Letter of Credit Guarantee a) Number Guaranteed (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp) a) Number Guaranteed (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp)
10) 11)
Customs Bond Guarantee
(Customs Bond)
Excise Guarantee a) Number
Guaranteed
(Unit) b) Guarantee
Value (Rp) c) Claim
Value (Rp) a) Number
Guaranteed
(Unit) b) Guarantee
Value (Rp) c) Claim
Value (Rp)
12) 13)
Provision of Management Consulting
Services related to
Guarantee Business Activities
Other Business Activities after
Obtaining Approval from OJK a) Number
Guaranteed
(Unit) b) Guarantee
Value (Rp) c) Claim
Value (Rp) a) Number
Guaranteed
(Unit) b) Guarantee
Value (Rp) c) Claim
Value (Rp)
14)
Total a) Number
Guaranteed
(Unit) b) Guarantee
Value (Rp) c) Claim
Value (Rp)
2. FORM 3200 EXPLANATION (LIST OF GUARANTEE CLAIM REPORT PER GUARANTEED LOCATION)
FORM 3200 LIST OF GUARANTEE CLAIM REPORT PER GUARANTEED LOCATION contains guarantee claim reports based on the guaranteed location, with the following explanations:
a. Credit Guarantee

No.
This position is filled with the sequential number in the form row.
Guaranteed Location (Province)
This position is filled with the provincial administrative region where the guaranteed party is located.
Productive Credit Guarantee – SME Credit Guarantee (Non KUR)
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Guarantee Company for the current year.
Productive Credit Guarantee – Micro Business Credit Guarantee Non-SME
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Guarantee Company for the current year.
Non-Productive Credit Guarantee
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Guarantee Company for the current year.
KUR Guarantee – Micro
a) Number Guaranteed (Unit)
This position is filled with the number of Super Micro KUR and Micro KUR guaranteed parties in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Guarantee Company for the current year.
KUR Guarantee – Non-Micro
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Guarantee Company for the current year.
Total
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Guarantee Company for the current year.

b. Other Guarantees

No.
This position is filled with the sequential number in the form row.
Guaranteed Location (Province)
This position is filled with the provincial administrative region where the guaranteed party is located.
Guarantee on Debt Instruments
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Guarantee Company for the current year.
Guarantee for Purchase of Goods in Installments
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Guarantee Company for the current year.
Trade Transaction Guarantee
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Guarantee Value (Rp)

This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Guarantee Company for the current year.
6) Procurement of Goods and/or Services (Surety Bond)
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Guarantee Company for the current year.
7) Bank Guarantee (Counter Bank Guarantee)
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Guarantee Company for the current year.
8) Domestic Documentary Letter of Credit Guarantee
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year.

b) Guarantee Value (Rp)
This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Guarantee Company for the current year.
9) Letter of Credit Guarantee
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Guarantee Company for the current year.
10) Customs Bond (Customs Bond)
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Guarantee Company for the current year.
11) Excise Guarantee
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Guarantee Value (Rp)

This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Guarantee Company for the current year.
12) Management Consulting Services Provision related to Guarantee Business Activities
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Guarantee Company for the current year.
13) Other Business Activities after Obtaining Approval from OJK
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Guarantee Company for the current year.
14) Total
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year.

P. FORM 3300: LIST OF GUARANTEE CLAIM REPORT PER GUARANTEE RECIPIENT LOCATION

FORM 3300 FORMAT (LIST OF GUARANTEE CLAIM REPORT PER GUARANTEE RECIPIENT LOCATION)
FORM 3300 LIST OF GUARANTEE CLAIM REPORT PER GUARANTEE RECIPIENT is prepared in the following format:
a. Credit Guarantee

No. Guarantee Recipient Location
(Province)
Productive Credit Guarantee –
SME Credit Guarantee (Non
KUR) a) Number
Guaranteed
(Unit) b) Guarantee
Value (Rp) c) Claim
Value (Rp)
4) 5)
Productive Credit Guarantee –
Micro Business Credit Guarantee
Non-SME
Non-Productive Credit Guarantee a) Number
Guaranteed
(Unit) b) Guarantee
Value (Rp) c) Claim
Value (Rp) a) Number
Guaranteed
(Unit) b) Guarantee
Value (Rp) c) Claim
Value (Rp)
6) 7)
KUR Guarantee -
Micro
KUR Guarantee -
Non-Micro a) Number
Guaranteed
(Unit) b) Guarantee
Value (Rp) c) Claim
Value (Rp) a) Number
Guaranteed
(Unit) b) Guarantee
Value (Rp) c) Claim
Value (Rp)
8)
Total a) Number
Guaranteed
(Unit) b) Guarantee
Value (Rp) c) Claim
Value (Rp)

b. Other Guarantees

2) 3)
No.
Location
Guarantee
Recipient
(Province)
Guarantee on Debt Instruments a) Number
Guaranteed
(Unit) b) Guarantee
Value (Rp) c) Claim Value (Rp)

Provision of Management Consulting
Services related to
Guarantee Business Activities
Other Business Activities after
Obtaining Approval from OJK a) Number
Guaranteed
(Unit) b) Guarantee
Value (Rp) c) Claim
Value (Rp) a) Number
Guaranteed
(Unit) b) Guarantee
Value (Rp) c) Claim
Value (Rp)
14)
Total a) Number
Guaranteed
(Unit) b) Guarantee
Value (Rp) c) Claim
Value (Rp)
2. FORM 3300 EXPLANATION (LIST OF GUARANTEE CLAIM REPORT PER GUARANTEE RECIPIENT LOCATION)
FORM 3300 LIST OF GUARANTEE CLAIM REPORT PER GUARANTEE RECIPIENT LOCATION contains guarantee claim reports based on the guarantee recipient location, with the following explanations:
a. Credit Guarantee

No.
This position is filled with the sequential number in the form row.
Guarantee Recipient Location (Province)
This position is filled with the provincial administrative region where the guarantee recipient is located.
Productive Credit Guarantee – SME Credit Guarantee (Non KUR)
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year.

c) Claim Value (Rp)
This position is filled with the claim value paid by the Guarantee Company for the current year.
4) Productive Credit Guarantee – Micro Business Credit Guarantee Non-SME
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Guarantee Company for the current year.
5) Non-Productive Credit Guarantee
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Guarantee Company for the current year.
6) KUR Guarantee – Micro
a) Number Guaranteed (Unit)
This position is filled with the number of Super Micro KUR and Micro KUR guaranteed parties in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year.

c) Claim Value (Rp)
This position is filled with the claim value paid by the Guarantee Company for the current year.
7) KUR Guarantee – Non-Micro
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Guarantee Company for the current year.
8) Total
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Guarantee Company for the current year. b. Other Guarantees

No.
This position is filled with the sequential number in the form row.
Guarantee Recipient Location (Province)
This position is filled with the provincial administrative region where the guarantee recipient is located.
Guarantee on Debt Instruments
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year.

b) Guarantee Value (Rp)
This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.

Guarantee for Installment Purchase of Goods
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Guarantee for Trade Transactions
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Guarantee for Procurement of Goods and/or Services (Surety Bond)
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Guarantee for Bank Guarantees (Counter Bank Guarantee)
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Guarantee for Domestic Documentary Credits
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Guarantee for Letters of Credit
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Guarantee for Customs (Customs Bond)
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Excise Guarantee
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Management Consulting Services Related to Guarantee Business Activities
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Other Business Activities after Obtaining Approval from OJK
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Total
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.

Q. FORM 3400: LIST OF DETAILED GUARANTEE CLAIM REPORTS BY ECONOMIC SECTOR

FORM 3400 FORMAT (LIST OF DETAILED GUARANTEE CLAIM REPORTS BY ECONOMIC SECTOR)
FORM 3400 LIST OF DETAILED GUARANTEE CLAIM REPORTS BY ECONOMIC SECTOR is arranged in the following format:

a. Credit Guarantees

No.
Economic Sector
Productive Credit Guarantee – SME Credit Guarantee (Non KUR)
a) Guaranteed Amount (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp)
Productive Credit Guarantee – Micro Business Credit Guarantee Non SME
a) Guaranteed Amount (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp)
Non-Productive Credit Guarantee
a) Guaranteed Amount (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp)
KUR Guarantee - Micro
a) Guaranteed Amount (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp)
KUR Guarantee - Non-Micro
a) Guaranteed Amount (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp)
Total
a) Guaranteed Amount (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp)

b. Other Guarantees

No.
Economic Sector
Guarantee on Debt Instruments
a) Guaranteed Amount (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp)
Guarantee for Installment Purchase of Goods
a) Guaranteed Amount (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp)
Guarantee for Trade Transactions
a) Guaranteed Amount (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp)
Guarantee for Procurement of Goods and/or Services (Surety Bond)
a) Guaranteed Amount (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp)
Guarantee for Bank Guarantees (Counter Bank Guarantee)
a) Guaranteed Amount (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp)
Guarantee for Domestic Documentary Credits
a) Guaranteed Amount (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp)
Guarantee for Letters of Credit
a) Guaranteed Amount (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp)
Guarantee for Customs (Customs Bond)
a) Guaranteed Amount (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp)
Excise Guarantee
a) Guaranteed Amount (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp)
Provision of Management Consulting Services Related to Guarantee Business Activities
a) Guaranteed Amount (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp)
Other Business Activities after Obtaining Approval from OJK
a) Guaranteed Amount (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp)
Total
a) Guaranteed Amount (Unit) b) Guarantee Value (Rp) c) Claim Value (Rp)

FORM 3400 EXPLANATION (LIST OF DETAILED GUARANTEE CLAIM REPORTS BY ECONOMIC SECTOR)
FORM 3400 LIST OF DETAILED GUARANTEE CLAIM REPORTS BY ECONOMIC SECTOR contains guarantee claim reports based on the economic sector of the guaranteed party, with the following explanations:

a. Credit Guarantees

No.
This item is filled with the sequence number in the form row.
Economic Sector
This item is filled with the sector of the guaranteed party based on the classification in the Regulation of the Central Bureau of Statistics regarding the Standard Classification of Indonesian Business Fields.
Productive Credit Guarantee – SME Credit Guarantee Non KUR
a) Guaranteed Amount (Unit)
This item is filled with the number of SMEs receiving Super Micro KUR and Micro KUR guarantees. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Productive Credit Guarantee – Micro Business Credit Guarantee Non SME
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Non-Productive Credit Guarantee
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
KUR Guarantee – Micro
a) Guaranteed Amount (Unit)
This item is filled with the number of Super Micro KUR and Micro KUR guarantees in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
KUR Guarantee – Non-Micro
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Total
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.

b. Other Guarantees

No.
This item is filled with the sequence number in the form row.
Economic Sector
This item is filled with the sector of the guaranteed party based on the classification in the Regulation of the Central Bureau of Statistics regarding the Standard Classification of Indonesian Business Fields.
Guarantee on Debt Instruments
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Guarantee for Installment Purchase of Goods
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Guarantee for Trade Transactions
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Guarantee for Procurement of Goods and/or Services (Surety Bond)
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Guarantee for Bank Guarantees (Counter Bank Guarantee)
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Guarantee for Domestic Documentary Credits
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Guarantee for Letters of Credit
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Guarantee for Customs (Customs Bond)
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Excise Guarantee
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Management Consulting Services Related to Guarantee Business Activities
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Other Business Activities after Obtaining Approval from OJK
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.
Total
a) Guaranteed Amount (Unit)
This item is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This item is filled with the guarantee ceiling provided by the Guarantee Company for the current year. c) Claim Value (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.

R. FORM 3500: LIST OF DETAILED GUARANTEE CLAIM REPORTS BY GUARANTEE RECIPIENT

FORM 3500 FORMAT (LIST OF DETAILED GUARANTEE CLAIM REPORTS BY CLAIM STATUS)
FORM 3500 LIST OF DETAILED GUARANTEE CLAIM REPORTS BY CLAIM STATUS is arranged in the following format:

a. Credit Guarantees

No.
Guarantee Recipient
Productive Credit Guarantee – SME Credit Guarantee (Non KUR)
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp) 1 Bank 2 Non-Bank Financial Institutions 3 Outside Financial Institutions Total
Productive Credit Guarantee – Micro Business Credit Guarantee Non SME
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Non-Productive Credit Guarantee
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
KUR Guarantee – Micro
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
KUR Guarantee – Non-Micro
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Total
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)

b. Other Guarantees

No.
Guarantee Recipient
Guarantee on Debt Instruments
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)

Bank
Non-Bank Financial Institutions
Outside Financial Institutions
Total

Guarantee for Installment Purchase of Goods
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Guarantee for Trade Transactions
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Guarantee for Procurement of Goods and/or Services (Surety Bond)
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Guarantee for Bank Guarantees (Counter Bank Guarantee)
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Guarantee for Domestic Documentary Credits
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Guarantee for Letters of Credit
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Guarantee for Customs (Customs Bond)
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Excise Guarantee
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Provision of Management Consulting Services Related to Guarantee Business Activities
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Other Business Activities after Obtaining Approval from OJK
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Total
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)

FORM 3500 EXPLANATION (LIST OF DETAILED GUARANTEE CLAIM REPORTS BY CLAIM STATUS)
FORM 3500 LIST OF DETAILED GUARANTEE CLAIM REPORTS BY CLAIM STATUS contains guarantee claim reports based on claim status, with the following explanations:

a. Credit Guarantees

No.
This item is filled with the sequence number in the form row.
Guarantee Recipient
This item is filled with the type of guarantee recipient, namely “Bank”, “Non-Bank Financial Institution”, and “Outside Financial Institution”.
Productive Credit Guarantee – SME Credit Guarantee (Non KUR)
a) Claim Submission (Rp)
This item is filled with the value of claims submitted to the Guarantee Company for the current year. b) Claim Processed (Rp) This item is filled with the value of claims being processed by the Guarantee Company for the current year. c) Claim Approved (Rp) This item is filled with the value of claims approved by the Guarantee Company for the current year. d) Claim Paid (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year. e) Claim Rejected (Rp) This item is filled with the value of claims rejected by the Guarantee Company for the current year. f) Claim Approved But Not Yet Paid (Rp) This item is filled with the value of claims approved but not yet paid by the Guarantee Company for the current year.
Productive Credit Guarantee – Micro Business Credit Guarantee Non SME
a) Claim Submission (Rp)
This item is filled with the value of claims submitted to the Guarantee Company for the current year. b) Claim Processed (Rp) This item is filled with the value of claims being processed by the Guarantee Company for the current year. c) Claim Approved (Rp) This item is filled with the value of claims approved by the Guarantee Company for the current year. d) Claim Paid (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year. e) Claim Rejected (Rp) This item is filled with the value of claims rejected by the Guarantee Company for the current year. f) Claim Approved But Not Yet Paid (Rp) This item is filled with the value of claims approved but not yet paid by the Guarantee Company for the current year.
Non-Productive Credit Guarantee
a) Claim Submission (Rp)
This item is filled with the value of claims submitted to the Guarantee Company for the current year. b) Claim Processed (Rp) This item is filled with the value of claims being processed by the Guarantee Company for the current year. c) Claim Approved (Rp) This item is filled with the value of claims approved by the Guarantee Company for the current year. d) Claim Paid (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year. e) Claim Rejected (Rp) This item is filled with the value of claims rejected by the Guarantee Company for the current year. f) Claim Approved But Not Yet Paid (Rp) This item is filled with the value of claims approved but not yet paid by the Guarantee Company for the current year.
KUR Guarantee – Micro
a) Claim Submission (Rp)
This item is filled with the value of claims submitted to the Guarantee Company for the current year. b) Claim Processed (Rp) This item is filled with the value of claims being processed by the Guarantee Company for the current year. c) Claim Approved (Rp) This item is filled with the value of claims approved by the Guarantee Company for the current year. d) Claim Paid (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year. e) Claim Rejected (Rp) This item is filled with the value of claims rejected by the Guarantee Company for the current year. f) Claim Approved But Not Yet Paid (Rp) This item is filled with the value of claims approved but not yet paid by the Guarantee Company for the current year.
KUR Guarantee – Non-Micro
a) Claim Submission (Rp)
This item is filled with the value of claims submitted to the Guarantee Company for the current year. b) Claim Processed (Rp) This item is filled with the value of claims being processed by the Guarantee Company for the current year. c) Claim Approved (Rp) This item is filled with the value of claims approved by the Guarantee Company for the current year. d) Claim Paid (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year.

e) Claim Rejected (Rp)
This item is filled with the value of claims rejected by the Guarantee Company for the current year. f) Claims Approved but Not Yet Paid (Rp) This item is filled with the value of claims approved but not yet paid by the Guarantee Company for the current year.
8) Total
a) Claim Submission (Rp)
This item is filled with the value of claims submitted to the Guarantee Company for the current year. b) Claims Processed (Rp) This item is filled with the value of claims currently being processed by the Guarantee Company for the current year. c) Claims Approved (Rp) This item is filled with the value of claims approved by the Guarantee Company for the current year. d) Claims Paid (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year. e) Claim Rejected (Rp) This item is filled with the value of claims rejected by the Guarantee Company for the current year. f) Claims Approved but Not Yet Paid (Rp) This item is filled with the value of claims approved but not yet paid by the Guarantee Company for the current year. b. Other Guarantees

No.
This item is filled with the sequence number in the form row.
Guarantee Recipient
This item indicates the type of guarantee recipient, namely "Bank", "Non-Bank Financial Institution", and "Outside Financial Institutions".
Guarantee on Debt Securities
a) Claim Submission (Rp)
This item is filled with the value of claims submitted to the Guarantee Company for the current year. b) Claims Processed (Rp) This item is filled with the value of claims currently being processed by the Guarantee Company for the current year. c) Claims Approved (Rp) This item is filled with the value of claims approved by the Guarantee Company for the current year. d) Claims Paid (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year. e) Claim Rejected (Rp) This item is filled with the value of claims rejected by the Guarantee Company for the current year. f) Claims Approved but Not Yet Paid (Rp) This item is filled with the value of claims approved but not yet paid by the Guarantee Company for the current year.
Installment Purchase Guarantee
a) Claim Submission (Rp)
This item is filled with the value of claims submitted to the Guarantee Company for the current year. b) Claims Processed (Rp) This item is filled with the value of claims currently being processed by the Guarantee Company for the current year. c) Claims Approved (Rp) This item is filled with the value of claims approved by the Guarantee Company for the current year. d) Claims Paid (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year. e) Claim Rejected (Rp) This item is filled with the value of claims rejected by the Guarantee Company for the current year. f) Claims Approved but Not Yet Paid (Rp) This item is filled with the value of claims approved but not yet paid by the Guarantee Company for the current year.
Trade Transaction Guarantee
a) Claim Submission (Rp)
This item is filled with the value of claims submitted to the Guarantee Company for the current year. b) Claims Processed (Rp) This item is filled with the value of claims currently being processed by the Guarantee Company for the current year. c) Claims Approved (Rp) This item is filled with the value of claims approved by the Guarantee Company for the current year. d) Claims Paid (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year. e) Claim Rejected (Rp) This item is filled with the value of claims rejected by the Guarantee Company for the current year. f) Claims Approved but Not Yet Paid (Rp) This item is filled with the value of claims approved but not yet paid by the Guarantee Company for the current year.
Goods and/or Services Procurement Guarantee (Surety Bond)
a) Claim Submission (Rp)
This item is filled with the value of claims submitted to the Guarantee Company for the current year. b) Claims Processed (Rp) This item is filled with the value of claims currently being processed by the Guarantee Company for the current year. c) Claims Approved (Rp) This item is filled with the value of claims approved by the Guarantee Company for the current year. d) Claims Paid (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year. e) Claim Rejected (Rp) This item is filled with the value of claims rejected by the Guarantee Company for the current year. f) Claims Approved but Not Yet Paid (Rp) This item is filled with the value of claims approved but not yet paid by the Guarantee Company for the current year.
Bank Guarantee Guarantee (Counter Bank Guarantee)
a) Claim Submission (Rp)
This item is filled with the value of claims submitted to the Guarantee Company for the current year. b) Claims Processed (Rp) This item is filled with the value of claims currently being processed by the Guarantee Company for the current year. c) Claims Approved (Rp) This item is filled with the value of claims approved by the Guarantee Company for the current year. d) Claims Paid (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year. e) Claim Rejected (Rp) This item is filled with the value of claims rejected by the Guarantee Company for the current year. f) Claims Approved but Not Yet Paid (Rp) This item is filled with the value of claims approved but not yet paid by the Guarantee Company for the current year.
Domestic Documentary Credit Guarantee
a) Claim Submission (Rp)
This item is filled with the value of claims submitted to the Guarantee Company for the current year. b) Claims Processed (Rp) This item is filled with the value of claims currently being processed by the Guarantee Company for the current year. c) Claims Approved (Rp) This item is filled with the value of claims approved by the Guarantee Company for the current year. d) Claims Paid (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year. e) Claim Rejected (Rp) This item is filled with the value of claims rejected by the Guarantee Company for the current year. f) Claims Approved but Not Yet Paid (Rp) This item is filled with the value of claims approved but not yet paid by the Guarantee Company for the current year.
Letter of Credit Guarantee
a) Claim Submission (Rp)
This item is filled with the value of claims submitted to the Guarantee Company for the current year. b) Claims Processed (Rp) This item is filled with the value of claims currently being processed by the Guarantee Company for the current year. c) Claims Approved (Rp) This item is filled with the value of claims approved by the Guarantee Company for the current year. d) Claims Paid (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year. e) Claim Rejected (Rp) This item is filled with the value of claims rejected by the Guarantee Company for the current year. f) Claims Approved but Not Yet Paid (Rp) This item is filled with the value of claims approved but not yet paid by the Guarantee Company for the current year.
Customs Guarantee (Customs Bond)
a) Claim Submission (Rp)
This item is filled with the value of claims submitted to the Guarantee Company for the current year. b) Claims Processed (Rp) This item is filled with the value of claims currently being processed by the Guarantee Company for the current year. c) Claims Approved (Rp) This item is filled with the value of claims approved by the Guarantee Company for the current year. d) Claims Paid (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year. e) Claim Rejected (Rp) This item is filled with the value of claims rejected by the Guarantee Company for the current year. f) Claims Approved but Not Yet Paid (Rp) This item is filled with the value of claims approved but not yet paid by the Guarantee Company for the current year.
Excise Guarantee
a) Claim Submission (Rp)
This item is filled with the value of claims submitted to the Guarantee Company for the current year. b) Claims Processed (Rp) This item is filled with the value of claims currently being processed by the Guarantee Company for the current year. c) Claims Approved (Rp) This item is filled with the value of claims approved by the Guarantee Company for the current year. d) Claims Paid (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year. e) Claim Rejected (Rp) This item is filled with the value of claims rejected by the Guarantee Company for the current year. f) Claims Approved but Not Yet Paid (Rp) This item is filled with the value of claims approved but not yet paid by the Guarantee Company for the current year.
Provision of Management Consulting Services related to Guarantee Business Activities
a) Claim Submission (Rp)
This item is filled with the value of claims submitted to the Guarantee Company for the current year. b) Claims Processed (Rp) This item is filled with the value of claims currently being processed by the Guarantee Company for the current year. c) Claims Approved (Rp) This item is filled with the value of claims approved by the Guarantee Company for the current year. d) Claims Paid (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year. e) Claim Rejected (Rp) This item is filled with the value of claims rejected by the Guarantee Company for the current year. f) Claims Approved but Not Yet Paid (Rp) This item is filled with the value of claims approved but not yet paid by the Guarantee Company for the current year.
Other Business Activities after Obtaining Approval from OJK
a) Claim Submission (Rp)
This item is filled with the value of claims submitted to the Guarantee Company for the current year. b) Claims Processed (Rp) This item is filled with the value of claims currently being processed by the Guarantee Company for the current year. c) Claims Approved (Rp) This item is filled with the value of claims approved by the Guarantee Company for the current year. d) Claims Paid (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year. e) Claim Rejected (Rp) This item is filled with the value of claims rejected by the Guarantee Company for the current year. f) Claims Approved but Not Yet Paid (Rp) This item is filled with the value of claims approved but not yet paid by the Guarantee Company for the current year.
Total
a) Claim Submission (Rp)
This item is filled with the value of claims submitted to the Guarantee Company for the current year. b) Claims Processed (Rp) This item is filled with the value of claims currently being processed by the Guarantee Company for the current year. c) Claims Approved (Rp) This item is filled with the value of claims approved by the Guarantee Company for the current year. d) Claims Paid (Rp) This item is filled with the value of claims paid by the Guarantee Company for the current year. e) Claim Rejected (Rp) This item is filled with the value of claims rejected by the Guarantee Company for the current year. f) Claims Approved but Not Yet Paid (Rp) This item is filled with the value of claims approved but not yet paid by the Guarantee Company for the current year.

S. FORM 4100: ASSET AND LIABILITY MATCHING ANALYSIS REPORT

FORM 4100 FORMAT (ASSET AND LIABILITY MATCHING ANALYSIS REPORT)
FORM 4100 ASSET AND LIABILITY MATCHING ANALYSIS REPORT LIST is arranged in the following format:

Asset Age Liabilities
< 1 year
1 year < age < 5 years
5 years < age < 10 years

10 years
Total

FORM 4100 EXPLANATION (ASSET AND LIABILITY MATCHING ANALYSIS REPORT)
FORM 4100 ASSET AND LIABILITY MATCHING ANALYSIS REPORT contains information regarding the recapitulation of assets and liabilities detailed by asset and liability ratios, with the following explanations:

Age
This item represents the age of assets, liabilities, or the asset-to-liability ratio, namely < 1 year, 1 year < age < 5 years, 5 years < age < 10 years, and > 10 years.
Assets
This item is filled with the value of the Guarantee Company's assets in the reporting period.
Liabilities
This item is filled with the value of the Guarantee Company's liabilities in the reporting period.

T. FORM 5100: GUARANTEE COMPANY OPERATIONAL PERFORMANCE

FORM 5100 FORMAT (GUARANTEE COMPANY OPERATIONAL PERFORMANCE)
FORM 5100 GUARANTEE COMPANY OPERATIONAL PERFORMANCE LIST is arranged in the following format:

No.
Financial Health Measurement
Criteria Analysis
Weight Value
Composite Value

Liquidity Ratio 10%
Gearing Ratio 35%
Profitability
a. Return on
Asset (ROA) 30%
35% b. Operating
Expense/
Operating
Income
(BOPO)
35%
c. Claims
against
IJP Income
35%

Self-assessment
Good Corporate
Governance
(GCG)
20%
7) Total Composite Financial Health
8) Guarantee Company Financial Health Category
2. FORM 5100 EXPLANATION (GUARANTEE COMPANY OPERATIONAL PERFORMANCE)
FORM 5100 GUARANTEE COMPANY OPERATIONAL PERFORMANCE contains operational performance, with the following explanations:

No.
This item is filled with the sequence number in the form row.
Financial Health Measurement
This item is filled with the financial health measurement in accordance with Financial Services Authority Circular Number 18/SEOJK.05/2018 concerning the Financial Health of Guarantee Institutions (SEOJK 18/2018), namely Liquidity Ratio, Gearing Ratio, Profitability (ROA, BOPO, and claims against IJP income), and self-assessment of good corporate governance.
Analysis
This item is filled with the results of financial health measurements calculated in accordance with SEOJK 18/2018.
Criteria Value
This item is filled with the criteria from the financial health measurement results determined in accordance with SEOJK 18/2018.
Weight
This item is filled with the weight of each financial health measurement in accordance with SEOJK 18/2018, namely 10% for liquidity ratio, 35% for gearing ratio, 35% for profitability (30% for ROA, 35% for BOPO, and 35% for claims against IJP income), and 20% for GCG self-assessment.
Composite
This item is filled with the result of the multiplication between column number 4) and column number 5).
Total Composite Financial Health
This item is filled with the total composite financial health calculated using the calculation method in accordance with SEOJK 18/2018.
Guarantee Company Financial Health Category
This item is filled with the financial health category of the Guarantee Company, namely the financial health level value (TKK) and the financial health category of the Guarantee Company determined in accordance with SEOJK 18/2018).

U. FORM 6100: SUBROGATION RECEIVABLES REPORT

FORM 6100 FORMAT (SUBROGATION RECEIVABLES REPORT)
FORM 6100 SUBROGATION RECEIVABLES REPORT is arranged in the following format:

No. Description Value

a. Beginning Balance
b. Added/(Subtracted):
i. Claim Payment
ii. Subrogation Installment
c. Ending Balance
FORM 6100 EXPLANATION (SUBROGATION RECEIVABLES REPORT)
FORM 6100 SUBROGATION RECEIVABLES REPORT contains a report on the development of subrogation receivables, with the following explanations:

No.
This item is filled with the sequence number in the form row.
Description
a. Beginning Balance
This item is the beginning balance of subrogation receivables at the start of the year. b. Added/(Subtracted)
i. Claim Payment
This item is the total claim payment from the start of the year to the reporting date.
ii. Subrogation Installment
This item is the total subrogation installment received by the Guarantee Company from the start of the year to the reporting date.
c. Ending Balance
This item is the ending balance of subrogation receivables on the reporting date.
Value
This item is filled with the value of the Beginning Balance, Claim Payment, Subrogation Installment, and Ending Balance items.

V. FORM 7100: GEARING RATIO REPORT

FORM 7100 FORMAT (GEARING RATIO REPORT)
FORM 7100 GEARING RATIO REPORT is arranged in the following format:
No. Business Description
Productive Business
Non-Productive Business
Total
Value
Guarantee
Covered
Individually
Net Equity
Gearing Ratio
(Row 1:2 Value)
FORM 7100 EXPLANATION (GEARING RATIO REPORT)
FORM 7100 GEARING RATIO REPORT contains a gearing ratio report detailed by productive and non-productive business, with the following explanations:

Value of Guarantee Covered Individually
This item is filled with the value of outstanding guarantees covered by the Guarantee Company.
Net Equity
This item is filled with the value of the Guarantee Company's net equity in accordance with applicable regulations.
Gearing Ratio
This item is filled with the ratio between the value of guarantees covered individually and net equity.

W. FORM 8100: CREDIT GUARANTEE QUALITY REPORT

FORM 8100 FORMAT (CREDIT GUARANTEE QUALITY REPORT)
FORM 8100 CREDIT GUARANTEE QUALITY REPORT is arranged in the following format:
No. Collectibility
Productive Business
Non-Productive Business
Total
Current
Special
Attention
Less Current
Doubtful
Loss
Total (Row
1+2+3+4+5)
Non-Performing
Guarantee/NPG
(Row 3+4+5
Value)
NPG Ratio
(Row 7:6 Value)
FORM 8100 EXPLANATION (CREDIT GUARANTEE QUALITY REPORT)
FORM 8100 CREDIT GUARANTEE QUALITY REPORT contains a report on the collectibility of guaranteed credits, namely current, special attention, less current, doubtful, and loss, detailed by productive and non-productive business, with the following explanations:

Collectibility: Current
This item is filled with the amount of guaranteed credits having Current collectibility.
Collectibility: Special Attention
This item is filled with the amount of guaranteed credits having Special Attention collectibility.
Collectibility: Less Current
This item is filled with the amount of guaranteed credits having Less Current collectibility.
Collectibility: Doubtful
This item is filled with the amount of guaranteed credits having Doubtful collectibility.
Collectibility: Loss
This item is filled with the amount of guaranteed credits having Loss collectibility.
Total
This item is filled with the total amount of guaranteed credits.
Non-Performing Guarantee/NPG
This item is filled with the amount of guaranteed credits having Less Current, Doubtful, and Loss collectibility.
NPG Ratio
This item is filled with the ratio between the amount of guaranteed credits having Less Current, Doubtful, and Loss collectibility and the total amount of guaranteed credits.

X. FORM 9100: TOP 10 NON PERFORMING GUARANTEE/NPG REPORT

FORM 9100 FORMAT (NON PERFORMING GUARANTEE/NPG)
FORM 9100 NON PERFORMING GUARANTEE/NPG is arranged in the following format:

No.
Guaranteed
Name
Collectibility
Guarantee
Recipient
Guarantee
Value
1.
2.
3.
4.

This copy is consistent with the original
Legal Director
Legal Department signed
Mufli Asmawidjaja
2. FORM 9100 EXPLANATION (NON-PERFORMING GUARANTEE/NPG)
FORM 9100 NON PERFORMING GUARANTEE/NPG contains a report on the 10 (ten) guaranteed parties with the largest Non Performing Guarantee/NPG values, with the following explanations:

No.
This item is filled with the sequence number in the form row.
Guaranteed Name
This item is filled with the name of the guaranteed party.
Collectibility
This item is filled with the collectibility of the guaranteed party.
Guarantee Recipient
This item is filled with the name of the guarantee recipient that disbursed the credit to the guaranteed party.
Guarantee Value
This item is filled with the value of the guarantee provided by the Guarantee Company.

Determined in Jakarta on January 6, 2023
EXECUTIVE HEAD OF INSURANCE SUPERVISOR,
PENSION FUND,
LEMBAGA PEMBIAYAAN, AND
OTHER FINANCIAL INSTITUTION SERVICES
FINANCIAL SERVICES AUTHORITY
REPUBLIC OF INDONESIA, signed
OGI PRASTOMIYONO

APPENDIX III
FINANCIAL SERVICES AUTHORITY CIRCULAR
REPUBLIC OF INDONESIA
NUMBER 1/SEOJK.05/2023
CONCERNING
MONTHLY REPORT OF GUARANTEE COMPANIES, SHARIA GUARANTEE COMPANIES, AND SHARIA BUSINESS UNITS

TABLE OF CONTENTS
TABLE OF CONTENTS................................................................................................. 2
I. SHARIA GUARANTEE COMPANY OR UUS PROFILE REPORT 4
A. FORM 0000 SHARIA GUARANTEE COMPANY OR UUS PROFILE.................................. 4
B. FORM 0020: BRANCH OFFICE DETAILS............................ 9
C. FORM 0030: EMPLOYEE COUNT DETAILS........................ 12
II. FINANCIAL STATEMENTS OF SHARIA GUARANTEE COMPANY OR UUS
(UUS) ............................................................................................... 13
A. FORM 1100 (FINANCIAL POSITION REPORT OF SHARIA
GUARANTEE COMPANY OR UUS).......................................... 13
B. FORM 1200: COMPREHENSIVE INCOME STATEMENT REPORT
OF SHARIA GUARANTEE COMPANY OR UUS ................... 30
C. FORM 1300 (CASH FLOW REPORT) ................................... 37
D. FORM 2100: INVESTMENT ASSET DETAIL LIST.............. 43
E. FORM 2200: IJK RECEIVABLES DETAIL LIST.................... 60
F. FORM 2300: CO-GUARANTEE AND REINSURANCE/SHARIA
GUARANTEE RECEIVABLES DETAIL LIST ........................................ 63
G. FORM 2400: OTHER ASSETS DETAIL LIST............... 67
H. FORM 2500: FIXED ASSETS – NET DETAIL LIST ........ 68
I. FORM 2600: COMMISSION LIABILITIES DETAIL LIST................ 69
J. FORM 2700: CO-GUARANTEE CLAIM LIABILITIES DETAIL LIST
................................................................................................ 71
K. FORM 2800: CO-GUARANTEE IJK LIABILITIES AND SHARIA REINSURANCE/SHARIA GUARANTEE DETAIL LIST .. 73
L. FORM 2900: OTHER LIABILITIES DETAIL LIST...... 78
M. FORM 3000: MANDATORY CONVERTIBLE OBLIGATION DETAIL LIST79
N. FORM 3100: SHARIA GUARANTEE DETAIL LIST.... 81
O. FORM 3200: SHARIA GUARANTEE CLAIM REPORT DETAIL LIST
PER GUARANTEED LOCATION ............................................ 85
P. FORM 3300: SHARIA GUARANTEE CLAIM REPORT DETAIL LIST
PER GUARANTEE RECIPIENT ......................................... 95

Q. FORM 3400: SHARIA GUARANTEE CLAIM REPORT DETAIL LIST
PER ECONOMIC SECTOR.......................................... 105
R. FORM 3500: SHARIA GUARANTEE CLAIM REPORT DETAIL LIST
PER CLAIM STATUS ................................................ 115
S. FORM 4100: ASSET AND LIABILITY MATCHING ANALYSIS REPORT............................................................................. 134
T. FORM 5100: OPERATIONAL PERFORMANCE OF SHARIA
GUARANTEE COMPANY OR UUS......................................... 135
U. FORM 6100: SUBROGATION RECEIVABLES REPORT................ 139
V. FORM 7100: GEARING RATIO REPORT ......................... 141
W. FORM 8100: FINANCING GUARANTEE QUALITY REPORT.............................................................................................. 142
X. FORM 9100: TOP 10 NON PERFORMING
GUARANTEE/NPG REPORT .................................................................. 144

I. SHARIA GUARANTEE COMPANY OR UUS PROFILE REPORT
A. FORM 0000 SHARIA GUARANTEE COMPANY OR UUS PROFILE

FORM 0000 FORMAT (SHARIA GUARANTEE COMPANY OR UUS PROFILE)
FORM 0000 SHARIA GUARANTEE COMPANY OR UUS PROFILE is arranged in the following format:
COMPANY PROFILE a. Company Name b. Taxpayer Identification Number (NPWP)
c. Office Address
d. Company Ownership Status e. Legal Entity Form f. Establishment Date g. Type of Business Activities Conducted h. Reporting Period
i. Company Organ

Number of Commissioners
Number of Directors
Number of Sharia Supervisory Board
j. Name of Sharia Business Unit (UUS) Leader k. Office Network Data
Head Office
UUS Office
Branch Office
l. Number of Employees
Head Office
UUS Office
Branch Office
m. Report Compiler and Person in Charge
Report Compiler
a) Full Name b) Position c) Telephone Number d) Mobile Number

e) Electronic Mail Address (E-mail)
2) Person in Charge of the Report
a) Full Name b) Position c) Telephone Number d) Mobile Phone Number e) Electronic Mail Address (E-mail)

EXPLANATION OF FORM 0000 (PROFILE OF SHARIA GUARANTEE COMPANY OR SHARIA BUSINESS UNIT)
FORM 0000 PROFILE OF SHARIA GUARANTEE COMPANY OR SHARIA BUSINESS UNIT contains all information regarding the profile of the Sharia Guarantee Company or Sharia Business Unit.

a. Company Name
This field is filled with the name of the Sharia Guarantee Company or Sharia Business Unit, including its legal entity form.

b. Taxpayer Identification Number (NPWP)
This field is filled with the Taxpayer Identification Number (NPWP) of the Sharia Guarantee Company or Sharia Business Unit.

c. Office Address
This field is filled with the complete address of the head office of the Sharia Guarantee Company or Sharia Business Unit.

d. Company Ownership Status
This field is filled with the following information:

State-Owned Company, in the event that the Sharia Guarantee Company or Sharia Business Unit is owned by the state either through capital participation by the central government or capital participation by the regional government;
National Private Company, in the event that the Sharia Guarantee Company or Sharia Business Unit is not owned by the state and there is no participation, either directly or indirectly, by foreign parties; or
Joint Private Company, in the event that there is participation, either directly or indirectly, by foreign parties in the Sharia Guarantee Company or Sharia Business Unit.

e. Legal Entity Form
This field is filled with the legal entity form of the Sharia Guarantee Company or Sharia Business Unit as stipulated in Article 2 of the Financial Services Authority Regulation Number 1/POJK.05/2017 concerning Business Licensing and Institutional Structure of Guarantee Institutions.

f. Date of Establishment
This field is filled with the day, month, and year of establishment of the Sharia Guarantee Company or Sharia Business Unit.

g. Type of Business Activity Conducted
This field is filled with the name of the guarantee business in guarantee activities as stipulated in Article 2 of the Financial Services Authority Regulation Number 2/POJK.05/2017 concerning the Conduct of Business by Guarantee Institutions, as amended by the Financial Services Authority Regulation Number 30/POJK.05/2018 concerning Amendments to the Financial Services Authority Regulation Number 2/POJK.05/2017 concerning the Conduct of Business by Guarantee Institutions.

h. Reporting Period
This field is filled with the end date of the period month, for example, January 31, 2023.

i. Company Organ
This field is filled with the number of commissioners, the number of Directors, and the number of Sharia supervisory boards in the Sharia Guarantee Company or Sharia Business Unit.

j. Name of Sharia Business Unit Leader
This field is filled with the name of the Sharia Business Unit leader.

k. Office Network Data
This field is filled with the number of office networks, namely:

Head Office;
Sharia Business Unit Office; and
Branch Office.
This field is detailed in FORM 0020: BRANCH OFFICE DETAILS.

l. Number of Employees
This field is filled with the number of employees owned by the Sharia Guarantee Company and Sharia Business Unit, covering all employees at:

Head Office;
Sharia Business Unit Office; and
Branch Office.
This field is detailed in FORM 0030: EMPLOYEE COUNT DETAILS.

m. Report Compiler and Person in Charge of the Report

Report Compiler
This field is filled with the complete data of Sharia Guarantee Company or Sharia Business Unit personnel acting as report compilation officers. a) Full Name This field is filled with the full name of the report compilation officer. b) Position This field is filled with the position of the report compilation officer. c) Telephone Number This field is filled with the telephone number of the department/division/work unit of the Director member in charge of the report. d) Mobile Phone Number This field is filled with the mobile phone number of the report compilation officer. e) Electronic Mail Address (E-mail) This field is filled with the e-mail address of the report compilation officer.
Person in Charge of the Report
This field is filled with the complete data of Director members acting as the person in charge of the report. a) Full Name This field is filled with the name of the Director member in charge of the report. b) Position This field is filled with the position of the Director member in charge of the report. c) Telephone Number This field is filled with the telephone number of the department/division/work unit of the Director member in charge of the report. d) Mobile Phone Number This field is filled with the mobile phone number of the Director member in charge of the report. e) Electronic Mail Address (E-mail) This field is filled with the e-mail address of the Director member in charge of the report.

B. FORM 0020: BRANCH OFFICE DETAILS

FORMAT OF FORM 0020 (BRANCH OFFICE DETAILS)
FORM 0020: BRANCH OFFICE DETAILS is arranged according to the following format:

Type of Office
Recording Letter Number
Date of Recording Letter
Location
a) Address b) District c) Regency/City d) Postal Code
Telephone Number
Number of Workforce
Name of Office Person in Charge
Date of Commencement of Operations
Office Building Ownership
Number of Employees
a) Male b) Female

EXPLANATION OF FORM 0020 (BRANCH OFFICE DETAILS)
FORM 0020: BRANCH OFFICE DETAILS contains branch office information as follows:

Type of Office
This field is filled with the name/title of the branch office.
Recording Letter Number
This field is filled with the letter number from the Financial Services Authority regarding the recording of the branch office.
Date of Recording Letter
This field is filled with the date of the letter from the Financial Services Authority regarding the recording of the opening of the branch office.
Location
a. Address
This field is filled with the complete address of the branch office. b. District This field is filled with the name of the district where the branch office is located.
c. Regency/City
This field is filled with the location of the regency/city where the branch office is located. d. Postal Code This field is filled with the postal code number of the branch office's location.
Telephone Number
This field is filled with the area code and telephone number of each branch office.
Number of Workforce
This field is filled with the number of workforce located at the office other than the head office, including the person in charge of the branch office, permanent workforce, contract workforce, and outsourcing workforce.
Name of Office Person in Charge
This field is filled with the name of the person in charge of each branch office.
Date of Commencement of Operations
This field is filled with the date the branch office commenced operations.
Office Building Ownership
This field is filled with the status of office building ownership, for example, owned by the Sharia Guarantee Company or Sharia Business Unit or rented.
Number of Employees
a) Male
This field is filled with the number of employees of male gender. b) Female This field is filled with the number of employees of female gender.

C. FORM 0030: EMPLOYEE COUNT DETAILS

FORMAT OF FORM 0030 (EMPLOYEE COUNT DETAILS)
FORM 0030: EMPLOYEE COUNT DETAILS is arranged according to the following format:
1). Employment Status
2). Number of Employees a. Permanent Employees b. Contract Employees
c. Outsourced Employees
Total
EXPLANATION OF FORM 0030 (EMPLOYEE COUNT DETAILS)
FORM 0030: EMPLOYEE COUNT DETAILS contains information on the number of employees based on employment status, namely permanent employees, contract employees, or outsourced workforce at the Sharia Guarantee Company or Sharia Business Unit. 1). Employment Status a. Permanent Employees This field is filled with the number of permanent employees owned by the Sharia Guarantee Company or Sharia Business Unit. b. Contract Employees This field is filled with the number of contract employees owned by the Sharia Guarantee Company or Sharia Business Unit.
c. Outsourced Employees
This field is filled with the number of outsourced employees owned by the Sharia Guarantee Company or Sharia Business Unit. 2). Number of Employees This field is filled with the total number of employees owned by the Sharia Guarantee Company or Sharia Business Unit based on their employment status.

II. FINANCIAL REPORT OF SHARIA GUARANTEE COMPANY OR SHARIA BUSINESS UNIT
A. FORM 1100 (FINANCIAL POSITION REPORT OF SHARIA GUARANTEE COMPANY OR SHARIA BUSINESS UNIT)

FORMAT OF FORM 1100 (FINANCIAL POSITION REPORT)
FORM 1100 (FINANCIAL POSITION REPORT OF SHARIA GUARANTEE COMPANY OR SHARIA BUSINESS UNIT) is arranged according to the following format:

Pos	Amount
a. ASSETS
1) Current Assets
a) Cash and Bank Giro
b) Investments
i. Deposits at Banks
ii. Sharia State Securities
iii. Sharia Securities Issued by Bank Indonesia
iv. Corporate Sukuk
v. Shares Listed on the Indonesia Stock Exchange
vi. Sharia Asset-Backed Securities
vii. Sharia Mutual Funds
viii. Sharia Medium Term Notes
ix. Sharia Repurchase Agreement
x. Sharia Real Estate Investment Fund in the Form of Collective Investment Contracts
xi. Land and Buildings
xii. Direct Participation in Companies in the Sharia Financial Services Sector in Indonesia
xiii. Regional Bonds
xiv. Infrastructure Investment Fund in the Form of Collective Investment Contracts
xv. Others
c) Kafalah Service Fee Receivables (IJK Receivables)
d) Co-Guarantee Receivables
e) Sharia Reinsurance/Sharia Re-guarantee Receivables
f) Accrued Income
g) Prepaid Expenses
h) Receivables in the Framework of Guarantee Restructuring
i) Deferred Tax Assets
j) Fixed Assets – Net
k) Intangible Assets – Net
l) Other Assets
Total Current Assets
2) Non-Current Assets
a) Investments
i. Deposits at Banks
ii. Sharia State Securities
iii. Sharia Securities Issued by Bank Indonesia
iv. Corporate Sukuk
v. Shares Listed on the Indonesia Stock Exchange
vi. Sharia Asset-Backed Securities
vii. Sharia Mutual Funds
viii. Sharia Medium Term Notes
ix. Sharia Repurchase Agreement
x. Sharia Real Estate Investment Fund in the Form of Collective Investment Contracts
xi. Land and Buildings
xii. Direct Participation in Companies in the Sharia Financial Services Sector in Indonesia
xiii. Regional Bonds
xiv. Infrastructure Investment Fund in the Form of Collective Investment Contracts
xv. Others
b) IJK Receivables
c) Co-Guarantee Receivables
d) Sharia Reinsurance/Sharia Re-guarantee Receivables
e) Accrued Income
f) Prepaid Expenses
g) Receivables in the Framework of Guarantee Restructuring
h) Deferred Tax Assets
i) Fixed Assets – Net
j) Intangible Assets – Net
k) Other Assets
Total Non-Current Assets
b. LIABILITIES
1) Current Liabilities
a) Claim Payables
b) Claim Provisions
c) IJK Accumulation
d) Deferred IJK
e) Tax Payables
f) Commission Payables
g) Co-Guarantee Claim Payables
h) Co-Guarantee IJK Payables
i) Reinsurance/IJK Contribution Payables for Re-guarantee
j) Accrued Expenses
k) Deferred Tax Liabilities
l) Mandatory Convertible Bonds
m) Post-Employment Benefit Liabilities
n) Other Liabilities
Total Current Liabilities
2) Non-Current Liabilities
a) Claim Payables
b) IJK Accumulation
c) Deferred IJK
d) Tax Payables
e) Commission Payables
f) Co-Guarantee Claim Payables
g) Co-Guarantee IJK Payables
h) Reinsurance/IJK Contribution Payables for Re-guarantee
i) Accrued Expenses
j) Deferred Tax Liabilities
k) Mandatory Convertible Bonds
l) Post-Employment Benefit Liabilities
m) Other Liabilities
Total Non-Current Liabilities
c. EQUITY
1) Capital
a) Paid-up Capital/Sharia Business Unit Working Capital
b) Capital Deposits Received in Advance
2) Reserves
a) General Reserve
b) Specific Reserve
c) Other Reserves
3) Grants
4) Retained Earnings/(Accumulated Deficit)
5) Profit/(Loss) for the Current Year
6) Other Comprehensive Income
Total Equity

EXPLANATION OF FORM 1100 (FINANCIAL POSITION REPORT)
FORM 1100 (FINANCIAL POSITION REPORT OF SHARIA GUARANTEE COMPANY OR SHARIA BUSINESS UNIT) contains the financial position report of the Sharia Guarantee Company or Sharia Business Unit, providing detailed explanations of the asset position, liability position, and equity position, as follows:

a. ASSETS

Current Assets
Current assets are assets that will be realized, or are intended to be sold or used, in the normal operating cycle, for trading purposes, or are expected to be realized within a period of 12 (twelve) months after the reporting date by the Sharia Guarantee Company or Sharia Business Unit.

a) Cash and Bank Giro
This field is filled with the amount of cash in the form of banknotes and coins that are legal tender in Indonesia, as well as giro funds in banks. The definition of cash also includes foreign banknotes and coins that are still valid as legal tender.

b) Investments
This field is filled with the placement of funds by the Sharia Guarantee Company or Sharia Business Unit in the form of:
i. Deposits at Banks
ii. Sharia State Securities
iii. Sharia Securities Issued by Bank Indonesia
iv. Corporate Sukuk
v. Shares Listed on the Indonesia Stock Exchange
vi. Sharia Asset-Backed Securities
vii. Sharia Mutual Funds
viii. Sharia Medium Term Notes
ix. Sharia Repurchase Agreement
x. Sharia Real Estate Investment Fund in the Form of Collective Investment Contracts
xi. Land and Buildings
xii. Direct Participation in Companies in the Sharia Financial Services Sector in Indonesia
xiii. Regional Bonds
xiv. Infrastructure Investment Fund in the Form of Collective Investment Contracts
xv. Others,
which are permitted in accordance with applicable regulations.
This field is detailed in FORM 2100: LIST OF INVESTMENT ASSET DETAILS.

c) Kafalah Service Fee Receivables (IJK Receivables) This field is filled with IJK receivables from the Indonesian Government, both central and regional, in connection with guarantee business activities that are government mandate programs, such as the Guarantee for People's Business Credit (KUR) program. Sharia Guarantee Companies or Sharia Business Units that receive mandates from the government must be proven by evidence of the mandate. This field is detailed in FORM 2200: LIST OF IJK RECEIVABLE DETAILS.

d) Co-Guarantee Receivables
This field is filled with receivables from co-guarantee partners in connection with claim payments that are the responsibility of the co-guarantee partner. This field is detailed in FORM 2300: LIST OF CO-GUARANTEE AND REINSURANCE/RE-GUARANTEE RECEIVABLE DETAILS.

e) Sharia Reinsurance/Sharia Re-guarantee Receivables This field is filled with receivables from Sharia reinsurance partners or Sharia re-guarantee partners in connection with claim payments that are the responsibility of the Sharia reinsurance partner or Sharia re-guarantee company. This field is detailed in FORM 2300: LIST OF CO-GUARANTEE AND REINSURANCE/RE-GUARANTEE RECEIVABLE DETAILS.

f) Accrued Income
This field is filled with income of the Sharia Guarantee Company or Sharia Business Unit that has been recognized in the reporting period but payment has not yet been received, such as income from bank deposit interest that has not yet been received.

g) Prepaid Expenses
This field is filled with payments for goods and/or services that will be used or provide benefits in the future. Some items included in the prepaid expenses category include prepaid rent, prepaid reinsurance IJK, prepaid co-guarantee IJK, and prepaid insurance.

h) Receivables in the Framework of Guarantee Restructuring This field is filled with loans provided by the Sharia Guarantee Company or Sharia Business Unit in the framework of guarantee restructuring.

i) Deferred Tax Assets
This field is filled with the amount of recoverable income tax in future periods as a result of deductible temporary differences and remaining loss carry-forwards.

j) Fixed Assets – Net
This field is filled with tangible assets owned by the Sharia Guarantee Company or Sharia Business Unit and used in operational activities in accordance with applicable financial accounting standards. This field is detailed in FORM 2500: LIST OF FIXED ASSETS – NET DETAILS.

k) Intangible Assets – Net
This field is filled with identifiable assets that do not have a physical form and are owned by the Sharia Guarantee Company or Sharia Business Unit for use in operational activities. This field is presented net after considering the accumulated amortization of intangible assets.

l) Other Assets
This field is filled with other assets that cannot be classified into any of the items in letters a through k above. This field is detailed in FORM 2400: LIST OF OTHER ASSETS DETAILS.

Non-Current Assets
Non-current assets are assets that will be realized, or are intended to be sold or used, in the normal operating cycle, for trading purposes, or are expected to be realized within a period of more than 12 (twelve) months after the reporting date by the Sharia Guarantee Company or Sharia Business Unit.

a) Investments
This field is filled with the placement of funds by the Sharia Guarantee Company or Sharia Business Unit in the form of:
i. Deposits at Banks
ii. Sharia State Securities
iii. Sharia Securities Issued by Bank Indonesia
iv. Corporate Sukuk
v. Shares Listed on the Indonesia Stock Exchange
vi. Sharia Asset-Backed Securities
vii. Sharia Mutual Funds
viii. Sharia Medium Term Notes
ix. Sharia Repurchase Agreement
x. Sharia Real Estate Investment Fund in the Form of Collective Investment Contracts
xi. Land and Buildings
xii. Direct Participation in Companies in the Sharia Financial Services Sector in Indonesia
xiii. Regional Bonds
xiv. Infrastructure Investment Fund in the Form of Collective Investment Contracts
xv. Others,
which are permitted in accordance with Sharia principles and applicable regulations.
This field is detailed in FORM 2100: LIST OF INVESTMENT ASSET DETAILS.

b) IJK Receivables
This field is filled with IJK receivables from the Indonesian Government, both central and regional, in connection with guarantee business activities that are government mandate programs, such as the Guarantee for People's Business Credit (KUR) program. Sharia Guarantee Companies or Sharia Business Units that receive mandates from the government must be proven by evidence of the mandate. This field is detailed in FORM 2200: LIST OF IJK RECEIVABLE DETAILS.

c) Co-Guarantee Receivables
This field is filled with receivables from co-guarantee partners in connection with claim payments that are the responsibility of the co-guarantee partner. This field is detailed in FORM 2300: LIST OF CO-GUARANTEE RECEIVABLE DETAILS.

d) Sharia Reinsurance/Sharia Re-guarantee Receivables This field is filled with receivables from Sharia reinsurance partners or Sharia re-guarantee partners in connection with claim payments that are the responsibility of the Sharia reinsurance partner or Sharia re-guarantee company. This field is detailed in FORM 2300: LIST OF CO-GUARANTEE AND REINSURANCE/RE-GUARANTEE RECEIVABLE DETAILS.

e) Accrued Income
This field is filled with income of the Sharia Guarantee Company or Sharia Business Unit that has been recognized in the reporting period but payment has not yet been received, such as income from bank deposit interest that has not yet been received.

f) Prepaid Expenses
This field is filled with payments for goods and/or services that will be used or provide benefits in the future. Some items included in the prepaid expenses category include prepaid rent, prepaid reinsurance IJK, prepaid co-guarantee IJK, and prepaid insurance.

g) Receivables in the Framework of Guarantee Restructuring This field is filled with loans provided by the Sharia Guarantee Company or Sharia Business Unit in the framework of guarantee restructuring.

h) Deferred Tax Assets
This field is filled with the amount of recoverable income tax in future periods as a result of deductible temporary differences and remaining loss carry-forwards.

i) Fixed Assets – Net
This field is filled with tangible assets owned by the Sharia Guarantee Company or Sharia Business Unit and used in operational activities in accordance with applicable financial accounting standards. This field is detailed in FORM 2500: LIST OF FIXED ASSETS – NET DETAILS.

j) Intangible Assets – Net
This field is filled with identifiable assets that do not have a physical form and are owned by the Sharia Guarantee Company or Sharia Business Unit. This field is presented net after considering the accumulated amortization of intangible assets.

k) Other Assets
This field is filled with other assets that cannot be classified into any of the items in letters a through k above. This field is detailed in FORM 2400: LIST OF OTHER ASSETS DETAILS.

b. LIABILITIES

Current Liabilities
Current liabilities are liabilities that will be settled within a period of 12 (twelve) months after the reporting date by the Sharia Guarantee Company or Sharia Business Unit.

a) Claim Payables
This field is filled with liabilities arising from the approval of claims submitted by guarantee recipients but not yet paid by the Sharia Guarantee Company or Sharia Business Unit. Claim payables are recognized and recorded when the claim is approved for payment (claim settled).

b) Claim Provisions
This field is filled with the estimate of claims that will be the responsibility of the Sharia Guarantee Company or Sharia Business Unit, the amount of which is recognized and recorded on the reporting date in accordance with applicable financial accounting standards and considering the formation of minimum claim provisions in accordance with applicable Financial Services Authority Regulations.

c) IJK Accumulation
This field is filled with IJK from guarantee recipients that has not yet been identified by the Sharia Guarantee Company or Sharia Business Unit.

d) Deferred IJK
This field is filled with the portion of IJK received by the Sharia Guarantee Company or Sharia Business Unit that has not yet been recognized as income on the reporting date, calculated individually for each guarantee and the amount is set proportionally for each relevant guarantee period. What is included in this field is deferred IJK.

e) Tax Payables
This field is filled with the amount of tax payable by the Sharia Guarantee Company or Sharia Business Unit.

f) Commission Payables
This field is filled with commission payables to other parties in connection with the closing of guarantees. This field is detailed in FORM 2600: LIST OF COMMISSION PAYABLES DETAILS.

g) Co-Guarantee Claim Payables
This field is filled with liabilities in co-guarantee guarantee activities together with co-guarantee partners. This field is detailed in FORM 2700: LIST OF CO-GUARANTEE CLAIM PAYABLES DETAILS.

h) Co-Guarantee IJK Payables
This field is filled with IJK payables that the Sharia Guarantee Company or Sharia Business Unit must pay to transfer claim risk. This field is detailed in FORM 2800: LIST OF CO-GUARANTEE IJK PAYABLES AND SHARIA REINSURANCE/SHARIA RE-GUARANTEE DETAILS.

i) Reinsurance/IJK Contribution Payables for Re-guarantee This field is filled with reinsurance/IJK re-guarantee contribution payables that the Sharia Guarantee Company or Sharia Business Unit must pay to Sharia reinsurance companies or Sharia re-guarantee companies. This field is detailed in FORM 2800: LIST OF CO-GUARANTEE IJK PAYABLES AND SHARIA REINSURANCE/SHARIA RE-GUARANTEE DETAILS.

j) Accrued Expenses
This field is filled with expenses that have occurred but payment has not yet been fulfilled, including salary expenses and rent expenses.

k) Deferred Tax Liabilities
This field is filled with the amount of income tax payable for future periods as a result of taxable temporary differences.

l) Mandatory Convertible Bonds
This field is filled with bonds issued by the Sharia Guarantee Company or Sharia Business Unit that must be converted into shares based on an agreement between the Sharia Guarantee Company or Sharia Business Unit and the bondholders. This field is detailed in FORM 3000: LIST OF MANDATORY CONVERTIBLE BONDS DETAILS.

m) Post-Employment Benefit Liabilities
This field is filled with work benefits other than termination of employment contracts and equity-based benefits that are payable after the worker has completed their working period.

n) Other Liabilities
This field is filled with other liabilities that cannot be included or classified into any of the items in letters a through n above. This field is detailed in FORM 2900: LIST OF OTHER LIABILITIES DETAILS.

Non-Current Liabilities
Non-current liabilities are liabilities that will be settled within a period of more than 12 (twelve) months after the reporting date by the Sharia Guarantee Company or Sharia Business Unit.

twelve) months after reporting by the Sharia Guarantee Company or Sharia Business Unit.

a) Claim Liabilities
This item is filled with liabilities arising from the approval of claims submitted by guarantee recipients but not yet paid by the Sharia Guarantee Company or Sharia Business Unit. Claim liabilities are recognized and recorded when the claim is approved for payment (claim settled).

b) IJK Retention
This item is filled with IJK from guarantee recipients that has not yet been identified by the Sharia Guarantee Company or Sharia Business Unit.

c) Deferred IJK
This item is filled with the portion of IJK received by the Sharia Guarantee Company or Sharia Business Unit that has not yet been recognized as income on the reporting date, calculated individually for each guarantee and set proportionally for each relevant guarantee period.

d) Tax Payables
This item is filled with the amount of tax payable by the Sharia Guarantee Company or Sharia Business Unit.

e) Commission Payables
This item is filled with commission payables to third parties in connection with the closure of guarantees. This item is detailed in FORM 2600: LIST OF COMMISSION PAYABLES DETAILS.

f) Co-Guarantee Claim Liabilities
This item is filled with liabilities in co-guarantee guarantee efforts together with co-guarantee partners. This item is detailed in FORM 2700: LIST OF CO-GUARANTEE CLAIM LIABILITIES DETAILS.

g) Co-Guarantee IJK Liabilities

This item is filled with IJK liabilities that the Sharia Guarantee Company or Sharia Business Unit must pay to transfer claim risks. This item is detailed in

FORM 2800: LIST OF CO-GUARANTEE IJK LIABILITIES AND SHARIA REINSURANCE/SHARIA GUARANTEE REINSURANCE DETAILS.

h) Reinsurance/IJK Contribution Liabilities for Guarantee Reinsurance This item is filled with reinsurance/IJK guarantee reinsurance contribution liabilities that must be paid by the Sharia Guarantee Company or Sharia Business Unit to reinsurance companies or guarantee reinsurance companies. This item is detailed in FORM 2800: LIST OF CO-GUARANTEE IJK LIABILITIES AND SHARIA REINSURANCE/SHARIA GUARANTEE REINSURANCE DETAILS.

i) Accrued Expenses
This item is filled with expenses that have occurred but whose payment has not yet been fulfilled, including salary expenses and rental expenses.

j) Deferred Tax Liabilities
This item is filled with the amount of income tax payable for future periods as a result of temporary taxable differences.

k) Mandatory Conversion Bonds
This item is filled with bonds issued by the Sharia Guarantee Company or Sharia Business Unit that must be converted into shares based on an agreement between the Sharia Guarantee Company or Sharia Business Unit and the bondholders. This item is detailed in FORM 3000: LIST OF MANDATORY CONVERSION BONDS DETAILS.

l) Post-Employment Benefit Liabilities
This item is filled with employment benefits other than termination benefits and equity-based benefits that are payable after the employee completes their working period.

m) Other Liabilities
This item is filled with other liabilities that cannot be included or classified into any of the items in letters a through m above. This item is detailed in FORM 2900: LIST OF OTHER LIABILITIES DETAILS.

c. EQUITY

Capital
a) Paid-in Capital/Sharia Business Unit Working Capital This item is filled with the paid-in capital of the Sharia Guarantee Company or the working capital of the Sharia Business Unit in accordance with applicable regulations.

b) Advance Capital Deposits
This item is filled with the amount of capital deposited but still in the recording process from the Financial Services Authority.

Reserves
This item is filled with reserves formed in accordance with the articles of association and/or decisions of the owners or the general meeting of shareholders, namely:

a) General Reserve
This item is filled with reserves formed from the allocation of net profit after tax, used to cover losses arising from the business activities of the Sharia Guarantee Company or Sharia Business Unit.

b) Specific Reserve
This item is filled with the portion of profit after tax allocated for specific purposes.

c) Other Reserves

This item is filled with reserves that are not included in the general reserve and specific reserve in letters a and b, including reserves formed from the difference in the revaluation of fixed assets.

Grants
This item is filled with grants received by the Sharia Guarantee Company or Sharia Business Unit.
Retained Earnings/(Accumulated Losses).
This item is filled with the retained/(absorbed) earnings/(losses) of the Sharia Guarantee Company or Sharia Business Unit at the beginning of the year.
Current Year Profit/(Loss)
This item is filled with the profit/(loss) of the Sharia Guarantee Company or Sharia Business Unit during the accounting period up to the reporting date.
Other Comprehensive Income
This item is filled with the profit/(loss) of other comprehensive income (OCI) by the Sharia Guarantee Company or Sharia Business Unit during the accounting period, from the beginning of the year to the reporting date. The value of this item must be the same as the Other Comprehensive Income item in the Other Comprehensive Income in FORM 1200: COMPREHENSIVE INCOME STATEMENT OF SHARIA GUARANTEE COMPANIES OR SHARIA BUSINESS UNITS.

B. FORM 1200: COMPREHENSIVE INCOME STATEMENT OF SHARIA GUARANTEE COMPANIES OR SHARIA BUSINESS UNITS

FORM 1200 FORMAT (COMPREHENSIVE INCOME STATEMENT)
FORM 1200 COMPREHENSIVE INCOME STATEMENT is prepared in the following format:

Item Amount a. Revenue

IJK Revenue
a) Gross IJK b) Co-Guarantee IJK Expense/Guarantee Reinsurance IJK/Reinsurance Contribution c) Guarantee Commission Revenue d) Guarantee Commission Expense Net IJK Revenue Total
Operational Revenue
a) Profit-Sharing Revenue b) Investment Revenue Other Than Profit-Sharing c) Fair Value Increase of Securities d) Gains on Sale of Financial Assets e) Sale of Investments in Associates/Joint Ventures f) Subrogation Revenue g) Other Operational Revenue Total Operational Revenue
Non-Operational Revenue
Total Revenue b. Expenses
Claims

Item Amount a) Claim Expenses b) Decrease/Increase in Claim Reserves Total Claim Expenses
2) Operational Expenses
a) Employee Expenses b) Workforce Development and Training Expenses c) General and Administrative Expenses d) Depreciation and Amortization Expenses e) Fair Value Decrease of Financial Assets f) Fair Value Increase of Financial Liabilities g) Losses on Sale of Financial Assets h) Losses on Sale of Securities i) Losses on Sale of Investments in Associates/Joint Ventures j) Other Operational Expenses Total Operational Expenses
3) Non-Operational Expenses
Total Expenses
c. Profit/(Loss) Before Tax
d. Tax Expenses e. Profit/(Loss) After Tax f. Other Comprehensive Income g. Comprehensive Profit/(Loss)

EXPLANATION OF FORM 1200 (COMPREHENSIVE INCOME STATEMENT)
FORM 1200 COMPREHENSIVE INCOME STATEMENT contains the comprehensive income statement of the Sharia Guarantee Company or Sharia Business Unit, providing detailed explanations of revenue positions, expenses, profit/(loss) before tax, tax expenses, profit/(loss) after tax, comprehensive income, and comprehensive profit/(loss), with explanations as follows:

a. Revenue

IJK Revenue
a) Gross IJK
This item is filled with IJK revenue obtained by the Sharia Guarantee Company or Sharia Business Unit from guarantee business activities, including IJK that is the portion of co-guarantee partner companies, guarantee reinsurance companies, or insurance companies. IJK obtained is recognized as revenue on an accrual basis allocated proportionally over the guarantee period.

b) Co-Guarantee IJK Expense/Guarantee Reinsurance IJK/Reinsurance Contribution This item is filled with the portion of Gross IJK that is paid out or represents the portion of co-guarantee partner companies/Sharia guarantee reinsurance companies/Sharia reinsurance companies. Co-guarantee IJK/Guarantee Reinsurance IJK/Reinsurance contribution is recognized and recorded in the same period as the recognition of the corresponding IJK revenue.

c) Guarantee Commission Revenue
This item is filled with commission revenue received by the Sharia Guarantee Company or Sharia Business Unit in connection with guarantee activities.

d) Guarantee Commission Expense
This item is filled with commission expenses incurred by the Sharia Guarantee Company or Sharia Business Unit in connection with guarantee activities.

Operational Revenue
a) Profit-Sharing Revenue
This item is filled with profit-sharing revenue obtained by the Sharia Guarantee Company or Sharia Business Unit from fund placements, including in the form of deposits, bonds, Government Securities, and other securities.

b) Investment Revenue Other Than Profit-Sharing This item is filled with investment revenue obtained by the Sharia Guarantee Company or Sharia Business Unit other than profit-sharing revenue.

c) Fair Value Increase of Securities
This item is filled with unrealized potential gains from securities measured at fair value through profit or loss, which is the positive difference between the fair value of financial assets on the reporting date and the fair value of those financial assets in the previous period.

d) Gains on Sale of Financial Assets
This item is filled with realizable gains from the sale of financial assets.

e) Sale of Investments in Associates/Joint Ventures.
This item is filled with realized gains from investments in associates or joint ventures.

f) Subrogation Revenue
This item is filled with revenue obtained from subrogation.

g) Other Operational Revenue
This item is filled with operational revenue obtained by the Sharia Guarantee Company or

Sharia Business Unit other than operational revenue in items in letters a through f above.

Non-Operational Revenue
This item is filled with all revenue/gains obtained other than from the main activities of the Sharia Guarantee Company or Sharia Business Unit, including gains from the sale of fixed assets.

b. Expenses

Claims
a) Claim Expenses
This item is filled with the value of settled claims that represent the portion of the Sharia Guarantee Company or Sharia Business Unit (self-retention). Claims are recognized as expenses when the claim submission has been approved by the Sharia Guarantee Company or Sharia Business Unit (accrual basis).

b) Decrease/Increase in Claim Reserves
This item is filled with the difference between the claim reserves of the current period and the previous period. In the event of a decrease in claim reserves, it will be recorded as a factor reducing claim expenses. Conversely, if there is an increase in claim reserves, it will be recorded as a factor increasing claim expenses.

Operational Expenses
a) Employee Expenses
This item is filled with basic salary expenses, wages, allowances, honoraria, and other human resource expenses outside of salaries, wages, allowances, and honoraria.

b) Workforce Development and Training Expenses This item is filled with expenses incurred by the Sharia Guarantee Company or Sharia Business Unit for workforce development and training.

d) Depreciation and Amortization Expenses.
This item is filled with fixed asset depreciation expenses and intangible asset amortization expenses.

e) Fair Value Decrease of Financial Assets.
This item is filled with unrealized potential losses from financial assets measured at fair value through profit or loss, which is the negative difference between the fair value of financial assets on the reporting date and the fair value of financial assets in the previous period.

f) Fair Value Increase of Financial Liabilities This item is filled with unrealized potential losses from financial liabilities measured at fair value through profit or loss, which is the positive difference between the fair value of financial liabilities on the reporting date and the fair value of those financial liabilities in the previous period.

g) Losses on Sale of Financial Assets
This item is filled with realized losses from the sale of financial assets.

h) Losses on Sale of Securities
This item is filled with realized losses from the sale of securities.

i) Losses on Sale of Investments in Associates/Joint Ventures This item is filled with realized losses from investments in associates or joint ventures.

j) Other Operational Expenses
This item is filled with other operational expenses that are not included in any of the items in letters a through i above.

Non-Operational Expenses
This item is filled with all expenses/losses borne by the Sharia Guarantee Company or Sharia Business Unit for non-operational activities.

c. Profit/(Loss) Before Tax
This item is filled with the positive/negative difference of operational profit/(loss) plus/minus non-operational revenue/expenses.

d. Tax Expenses
This item is filled with deferred tax expenses related to the amount of deferred tax liabilities recognized for the current year period up to the reporting date.

e. Profit/(Loss) After Tax
This item is filled with profit/(loss) after income tax for the current period.

f. Other Comprehensive Income
This item is filled with, among others:

Difference in revaluation of fixed assets;
Adjustment of defined benefit employment benefits; and
Gains (losses) from unrealized increases/decreases in investment value.

g. Comprehensive Profit/(Loss)
This item is filled with the value of net profit (loss) after tax plus other comprehensive income.

C. FORM 1300 (CASH FLOW STATEMENT)

FORM 1300 FORMAT (CASH FLOW STATEMENT)
FORM 1300 Cash Flow Statement is prepared in the following format:

Item Month Before Month After a. Cash Flows From Operating Activities

Cash Inflows
a) IJK Revenue b) Co-Guarantee Claim Receipts c) Guarantee Reinsurance/Reinsurance Claim Receipts d) Other Operational Receipts e) Non-Operational Receipts Total Cash Inflows From Operating Activities
Cash Outflows
a) Co-Guarantee IJK Payment/Guarantee Reinsurance IJK/Reinsurance Contribution b) Claim Payments to Guarantee Recipients c) Other Operational Expense Payments d) Other Non-Operational Expense Payments Total Cash Outflows From Operating Activities
Net Cash Flows From Operating Activities
b. Cash Flows From Investing Activities

Item Month Before Month After

Cash Inflows
a) Investment Result Receipts b) Fixed Asset Sale Receipts c) Investment Sale Result Receipts Total Cash Inflows From Investing Activities
Cash Outflows
a) Permitted Investment Placements b) Fixed Asset Acquisitions Total Cash Outflows From Investing Activities
Net Cash Flows From Investing Activities
c. Cash Flows From Financing Activities
Cash Inflows
a) Capital Deposit Receipts b) Mandatory Conversion Bond Issuance c) Other Receipts Total Cash Inflows From Financing Activities
Cash Outflows
a) Dividend Payments b) Other Expenditures
Total Cash Outflows From Financing Activities

Item Month Before Month After
3) Net Cash Flows From Financing Activities
d. Increase (Decrease) in Cash e. Beginning Cash Balance f. Ending Cash Balance
2. EXPLANATION OF FORM 1300 (CASH FLOW STATEMENT)
FORM 1300 CASH FLOW STATEMENT contains the cash flow statement of the Sharia Guarantee Company or Sharia Business Unit, providing detailed explanations of cash flows from operating activities, cash flows from investing activities, cash flows from financing activities, increase (decrease) in cash, beginning cash balance, and ending cash balance, with explanations as follows:

a. Cash Flows from Operating Activities

Cash Inflows
a) IJK Revenue
This item is filled with IJK revenue obtained by the Sharia Guarantee Company or Sharia Business Unit from guarantee business activities, including IJK that is the portion of co-guarantee partner companies/Sharia guarantee reinsurance companies/Sharia reinsurance companies.

b) Co-Guarantee Claim Receipts
This item is filled with claim receipts from co-guarantee partners that represent the portion of the Sharia Guarantee Company or Sharia Business Unit.

c) Guarantee Reinsurance/Reinsurance Claim Receipts This item is filled with claim receipts from Sharia guarantee reinsurance partner companies, which represent the portion of the Sharia Guarantee Company or Sharia Business Unit.

d) Other Operational Receipts

This item is filled with cash receipts from operational activities that are not included in items in letters a through c above.

e) Non-Operational Receipts
This item is filled with cash receipts from non-operational activities.

Cash Outflows
a) Co-Guarantee IJK Payment/Guarantee Reinsurance IJK/Reinsurance Contribution This item is filled with all cash expenditures for Co-Guarantee IJK/Guarantee Reinsurance IJK/Reinsurance Contribution payments.

b) Claim Payments to Guarantee Recipients
This item is filled with all cash expenditures for claim payments to guarantee recipients.

c) Other Operational Expense Payments
This item is filled with all cash expenditures for operational activities that are not included in items in letters a and b above.

d) Other Non-Operational Expense Payments
This item is filled with all cash expenditures from non-operational activities.

Net Cash Flows From Operating Activities
This item is filled with net cash obtained from or used for operating activities.

b. Cash Flows from Investing Activities

Cash Inflows
a) Investment Result Receipts
This item is filled with receipts of all investment results conducted by the Sharia Guarantee Company or Sharia Business Unit, whether in the form of profit-sharing or other investment results.

b) Fixed Asset Sale Receipts
This item is filled with cash receipts for fixed asset sale transactions, including land and buildings.

c) Investment Sale Result Receipts

This item is filled with investment result receipts from the sale of investments.

Cash Outflows
a) Permitted Investment Placements
This item contains all cash expenditures used for investments, including fund placements in the form of deposits at banks and the purchase of securities.

b) Fixed Asset Acquisitions
This item is filled with cash expenditures for fixed asset purchase transactions, including land and buildings.

Net Cash Flows From Investing Activities
This item is filled with net cash obtained from or used for investing activities.

c. Cash Flows from Financing Activities

Cash Inflows
a) Capital Deposit Receipts
This item is filled with receipts of capital deposits/additional capital of the Sharia Guarantee Company or Sharia Business Unit from shareholders.

b) Mandatory Conversion Bond Issuance
This item is filled with funds obtained from the issuance of mandatory conversion bonds.

c) Other Receipts
This item is filled with cash receipts from financing activities that are not included in items in letters a and b above.

Cash Outflows
a) Dividend Payments
This item is filled with dividend payments made by the Sharia Guarantee Company or Sharia Business Unit to the shareholders of the Sharia Guarantee Company or Sharia Business Unit.

b) Other Expenditures

This item is filled with the recording of all cash expenditures for other financing activities.

Net Cash Flows From Financing Activities
This item is filled with net cash obtained from or used for financing activities.

d. Increase (Decrease) in Cash
This item is filled with the net increase or decrease in cash and cash equivalents up to the reporting date period.

e. Beginning Cash Balance
This item is filled with cash and cash equivalents at the beginning of the reporting fiscal year of the Sharia Guarantee Company or Sharia Business Unit.

f. Ending Cash Balance
This item is filled with cash and cash equivalents at the beginning of the reporting fiscal year of the Sharia Guarantee Company or Sharia Business Unit.

D. FORM 2100: LIST OF INVESTMENT ASSET DETAILS

FORM 2100 FORMAT (LIST OF INVESTMENT ASSET DETAILS)
FORM 2100: LIST OF INVESTMENT ASSET DETAILS is prepared in the following format:

a. Deposits

Current Category
a) b) c) d) e)
No. Counterparty Code
Issuer Number
Cheque Value i. Name
Bank
ii. Branch
Bank

etc.
Total f) g) h) i) j)
Rate of
Return
Duration Description
Automatic
Roll Over
(ARO)
CKPN
Net Total i.
Start ii.
Maturity iii.
Tenor i.
Individual ii.
Collective

Non-Current Category
a) b) c) d) e)
No. Counterparty Code
Issuer Number
Cheque Value i. Name
Bank
ii. Branch
Bank

etc.
Total f) g) h) i) j)
Rate of
Return
Duration
Description
ARO
CKPN
Net Total i.
Start ii.
Maturity iii.
Tenor i.
Individual ii.
Collective

b. Sharia Securities

Current Category
a) b) c) d) e)
No.
Type of
Sharia
Securities
Name of
Sharia
Securities
Issuer Name
Investment Manager/
Broker

etc.
Total f) g) h) i) j)
Issuer
Code
Rating
Rating
Agency
Measurement
Category
Duration
i. Issuance
Date ii.
Maturity
Date k) l) m) n)
Yield or Coupon Value
Net
Asset
Value
(NAV) or
Share
Price
Unit
Participation
(UP) or
Share
Nominal
i. Yield
Rate or Coupon
ii. Type of
Yield or
Coupon i.
Last
Month ii.
Reporting
Month o) p)
CKPN
Net Total
i. Individual ii. Collective

Non-Current Category
a) b) c) d) e)
No.
Type of
Sharia
Securities
Name of
Sharia
Securities
Issuer Name
Investment Manager/
Broker

etc.
Total f) g) h) i) j)
Issuer
Code
Rating
Rating
Agency
Measurement
Category
Duration
i. Issuance
Date ii.
Maturity
Date k) l) m) n)
Yield or Coupon
NAV or
Share
Price
UP or
Share
Nominal
i. Yield
Rate or Coupon
ii. Type of
Yield or
Coupon i.
Last
Month ii.
Reporting
Month o) p)
CKPN
Net Total
i. Individual ii. Collective

c. Land and Buildings

Current Category
a) b) c) d)
No. Type Address Legal Status

etc.
Total e) f) g) h)
Acquisition
Value
Market Value
CKPN
Net Total i.
Individual ii.
Collective
2) Non-Current Category
a) b) c) d)
No. Type Address Legal Status etc.
Total e) f) g) h)
Acquisition
Value
Market Value
CKPN
i. Net Total
Individual ii.
Collective

d. Direct Participation

Current Category

No. Investee Name Participation Method Date of Start of Participation 1.
2. etc.
Total

a) b) c) d)
Ownership
Percentage
Acquisition
Value
Total
Reporting
Month
CKPN
Net Total i.
Individual ii.
Collective
Non-Current Category
a) b) c) d)
No. Investee Name Participation Method Date of Start of Participation 1.

etc.
Total e) f) g) h) i)
Ownership
Percentage
Acquisition
Value
Total
Reporting
Month
CKPN Net Total i.
Individual ii.
Collective
EXPLANATION OF FORM 2100 (LIST OF INVESTMENT ASSET DETAILS)
FORM 2100 LIST OF INVESTMENT ASSET DETAILS contains details of investment assets including deposits, securities, land and buildings, and direct participation, with explanations as follows:

a. Deposits

Current Category
The current category is deposits that are realized within a period of more than 12 (twelve) months after reporting by the Sharia Guarantee Company or Sharia Business Unit.

a) No.
This item is filled with the row sequence in the form.

b) Counterparty Code
This item is filled with the code of the issuer where the Sharia Guarantee Company or Sharia Business Unit

placing funds in the form of deposits as issued by Bank Indonesia. c) Issuer
i. Bank Name
This field is filled with the full name of the bank where the Sharia Guarantee Company or UUS places funds in the form of deposits.
ii. Bank Branch
This field is filled with the name of the branch of the bank where the Sharia Guarantee Company or UUS places funds in the form of deposits. d) Bill Number This field is filled with the bill number of the deposit. e) Value This field is filled with the deposit nominal for the monthly reporting period. f) Return Rate This field is filled with the deposit return rate at the bank. g) Term
i. Start
This field is filled with the date, month, and year the placement of funds in the form of deposits at the bank begins.
ii. Maturity
This field is filled with the date, month, and year of the deposit maturity at the bank.
iii. Tenor
This field is filled with the term of the deposit calculated as having a term of more than 1 (one) month at the bank. h) Automatic Roll Over (ARO) Description This field is filled with a description if the deposit at the bank is automatically renewed (ARO). Filled with "Yes" or "No".

i) Impairment Loss Reserve (CKPN)
i. Individual
This field is filled with the method of forming CKPN individually.
ii. Collective
This field is filled with the method of forming CKPN collectively. j) Net Amount This field is filled with the deposit value after considering individual CKPN or collective CKPN for the monthly reporting period.
2) Non-Current Category
The non-current category is deposits that are realized in a period of more than 12 (twelve) months after reporting by the Sharia Guarantee Company or UUS. a) No. This field is filled with the row sequence in the form. b) Counterparty Code This field is filled with the code of the issuer where the Sharia Guarantee Company or UUS places funds in the form of deposits as issued by Bank Indonesia. c) Issuer
i. Bank Name
This field is filled with the full name of the bank where the Sharia Guarantee Company or UUS places funds in the form of deposits.
ii. Bank Branch
This field is filled with the name of the branch of the bank where the Sharia Guarantee Company or UUS places funds in the form of deposits. d) Bill Number This field is filled with the bill number of the deposit.

e) Value
This field is filled with the deposit nominal for the monthly reporting period. f) Return Rate This field is filled with the deposit return rate at the bank. g) Term
i. Start
This field is filled with the date, month, and year the placement of funds in the form of deposits at the bank begins.
ii. Maturity
This field is filled with the date, month, and year of the deposit maturity at the bank.
iii. Tenor
This field is filled with the term of the deposit calculated as having a term of more than 1 (one) month at the bank. h) ARO Description This field is filled with a description if the deposit at the bank is automatically renewed (ARO). Filled with "Yes" or "No". i) CKPN
i. Individual
This field is filled with the method of forming CKPN individually.
ii. Collective
This field is filled with the method of forming CKPN collectively. j) Net Amount This field is filled with the deposit value after considering individual CKPN or collective CKPN for the monthly reporting period. b. Sharia Securities

Current Category
The current category is Sharia-based securities that are realized, or intended to be sold or used, in the normal operating cycle, for trading purposes, or are expected to be realized within a period of 12 (twelve) months after reporting by the Sharia Guarantee Company or UUS. a) No. This field is filled with the row sequence in the form. b) Type of Sharia Securities This field is filled with the type of security, namely:

State Sharia Securities (including state sukuk or Indonesian retail sukuk or ORI, Treasury Bills or SPN, State Sharia Securities or SBSN);
Commercial Sharia Securities (Commercial Paper/CP);
Sharia MTN;
Sharia Stocks;
Sharia Asset-Backed Securities;
Sharia Mutual Funds;
Sukuk; or
Other Sharia Securities.
c) Name of Sharia Securities
This field is filled with the name of the Sharia security. d) Issuer Name This field is filled with the name of the party that is the issuer of the security. e) Investment Manager/Broker Name This field is filled with the name of the party that is the Investment Manager or broker of the security. f) Issuer Code This field is filled with the issuer code where the Sharia Guarantee Company or UUS places funds in the form of securities as issued by the Stock Exchange or Exchange Authority. g) Rating This field is filled with the rating of the security issued by a rating agency.

h) Rating Agency
This field is filled with the name of the internationally recognized rating agency. i) Measurement Category This field is filled with the asset measurement category in accordance with applicable Sharia financial accounting standards and amortized cost. j) Term:
i. Issuance Date
This field is filled with the date, month, and year the placement of funds in the form of securities begins.
ii. Maturity Date
This field is filled with the date, month, and year of the security maturity. k) Return or Coupon
i. Return Rate or Coupon Rate
This field is filled with the return rate of the security.
ii. Type of Return or Coupon
This field is filled with the type of return. For returns based on Sharia principles, they are measured as fixed. l) Net Asset Value (NAV) or Share Price This field is filled with the net asset value for investments in the form of mutual funds or the price per share for investments in the form of stocks. m) Participation Units (UP) or Share This field is filled with the value of participation units for investments in the form of mutual funds or the number of participations per share for investments in the form of stocks. n) Nominal
i. Last Month
This field is filled with the amount for the previous reporting period.

ii. Reporting Month
This field is filled with the amount for the monthly reporting period. o) CKPN
i. Individual
This field is filled with the method of forming CKPN individually.
ii. Collective
This field is filled with the method of forming CKPN collectively. p) Net Amount This field is filled with the security value after considering individual CKPN or collective CKPN for the monthly reporting period.
2) Non-Current Category
The non-current category is Sharia-based securities that are realized, or intended to be sold or used, in the normal operating cycle, for trading purposes, or are expected to be realized in a period of more than 12 (twelve) months after reporting by the Sharia Guarantee Company or UUS. a) No. This field is filled with the row sequence in the form. b) Type of Sharia Securities This field is filled with the type of security, namely:

State Sharia Securities (including state sukuk or Indonesian retail sukuk or ORI, Treasury Bills or SPN, State Sharia Securities or SBSN);
Commercial Sharia Securities (Commercial Paper/CP);
Sharia MTN;
Sharia Stocks;
Sharia Asset-Backed Securities;
Sharia Mutual Funds;
Sukuk; or
Other Sharia Securities
c) Name of Sharia Securities
This field is filled with the name of the security. d) Issuer Name This field is filled with the name of the party that is the issuer of the security. e) Investment Manager/Broker Name This field is filled with the name of the party that is the Investment Manager or broker of the security. f) Issuer Code This field is filled with the issuer code where the Sharia Guarantee Company or UUS places funds in the form of securities as issued by the Stock Exchange or Exchange Authority. g) Rating This field is filled with the rating of the security issued by a rating agency. h) Rating Agency This field is filled with the name of the internationally recognized rating agency. i) Measurement Category This field is filled with the asset measurement category in accordance with applicable Sharia financial accounting standards and amortized cost. j) Term
i. Issuance Date
This field is filled with the date, month, and year the placement of funds in the form of securities begins.
ii. Maturity Date
This field is filled with the date, month, and year of the security maturity. k) Return or Coupon
i. Return Rate or Coupon Rate
This field is filled with the return rate of the security.

ii. Type of Return or Coupon
This field is filled with the type of return. For returns based on Sharia principles, they are measured as fixed. l) NAV or Share Price This field is filled with the net asset value for investments in the form of mutual funds or the price per share for investments in the form of stocks. m) UP or Share This field is filled with the value of participation units for investments in the form of mutual funds or the number of participations per share for investments in the form of stocks. n) Nominal
i. Last Month
This field is filled with the amount for the previous reporting period.
ii. Reporting Month
This field is filled with the amount for the monthly reporting period. o) CKPN
i. Individual
This field is filled with the method of forming CKPN individually.
ii. Collective
This field is filled with the method of forming CKPN collectively. p) Net Amount This field is filled with the security value after considering individual CKPN or collective CKPN for the monthly reporting period.
c. Land and Buildings

Current Category
The current category is land and buildings that are realized or intended to be sold in the normal operating cycle within a period of 12 (twelve) months after reporting by the Sharia Guarantee Company or UUS. a) No. This field is filled with the row sequence in the form. b) Type This field is filled with either "Land" or "Building". c) Address This field is filled with the address of the land or building. d) Legal Status This field is filled with land or building ownership certificates, including Land Ownership Certificate (SHM), Business Use Right Certificate (HGU), Use Right Certificate, and Building Use Right Certificate (SHGB). e) Acquisition Value This field is filled with the acquisition value of the land or building. f) Market Value This field is filled with the market value of the land or building for the reporting period. g) CKPN
i. Individual
This field is filled with the method of forming CKPN individually.
ii. Collective
This field is filled with the method of forming CKPN collectively. h) Net Amount This field is filled with the security value after considering individual CKPN or collective CKPN for the monthly reporting period.
Non-Current Category
The non-current category is land and buildings that are realized or intended to be sold in the normal operating cycle in a period of more than 12 (twelve) months after reporting by the Sharia Guarantee Company or UUS.

a) No.
This field is filled with the row sequence in the form. b) Type This field is filled with either "Land" or "Building". c) Address This field is filled with the address of the land or building. d) Legal Status This field is filled with land or building ownership certificates, including Land Ownership Certificate (SHM), Business Use Right Certificate (HGU), Use Right Certificate, and Building Use Right Certificate (SHGB). e) Acquisition Value This field is filled with the acquisition value of the land or building. f) Market Value This field is filled with the market value of the land or building for the reporting period. g) CKPN
i. Individual
This field is filled with the method of forming CKPN individually.
ii. Collective
This field is filled with the method of forming CKPN collectively. h) Net Amount This field is filled with the security value after considering individual CKPN or collective CKPN for the monthly reporting period. d. Direct Investment

Current Category
The current category is direct investments that are realized within a period of 12 (twelve) months after reporting by the Sharia Guarantee Company or UUS. a) No. This field is filled with the row sequence in the form.

b) Investee Name
This field is filled with the name of the investee company where the Sharia Guarantee Company or UUS makes direct investments. c) Investment Method This field is filled with one of the investment methods, namely the cost method or the equity method. d) Investment Start Date This field is filled with the date, month, and year the investment in the investee company effectively begins. e) Ownership Percentage This field is filled with the percentage of investment in the investee company. f) Acquisition Value This field is filled with the acquisition value at the time of making the investment. g) Reporting Month Amount This field is filled with the amount for the monthly reporting period. h) CKPN
i. Individual
This field is filled with the method of forming CKPN individually.
ii. Collective
This field is filled with the method of forming CKPN collectively. i) Net Amount This field is filled with the security value after considering individual CKPN or collective CKPN for the monthly reporting period.
2) Non-Current Category
The non-current category is direct investments that are realized in a period of more than 12 (twelve) months after reporting by the Sharia Guarantee Company or UUS. a) No.

This field is filled with the row sequence in the form. b) Investee Name This field is filled with the name of the investee company where the Sharia Guarantee Company or UUS makes direct investments. c) Investment Method This field is filled with one of the investment methods, namely the cost method or the equity method. d) Investment Start Date This field is filled with the date, month, and year the investment in the investee company effectively begins. e) Ownership Percentage This field is filled with the percentage of investment in the investee company. f) Acquisition Value This field is filled with the acquisition value at the time of making the investment. g) Reporting Month Amount This field is filled with the amount for the monthly reporting period. h) CKPN
i. Individual
This field is filled with the method of forming CKPN individually.
ii. Collective
This field is filled with the method of forming CKPN collectively. i) Net Amount This field is filled with the security value after considering individual CKPN or collective CKPN for the monthly reporting period.

E. FORM 2200: LIST OF DETAILED IJK RECEIVABLES

FORM 2200 LIST OF DETAILED IJK RECEIVABLES FORMAT
FORM 2200 (LIST OF DETAILED IJK RECEIVABLES) is prepared in the following format:

No. Name of Guarantor Recipient
Type of Guarantee Product
Guarantee
Amount
Insured (Unit)
Financing/Project Value (Rp)
1.
2.
3. etc.
7) 8) 9) 10)
Outstanding Guarantee Value
Guarantee (Rp)
IJK Receivable Value
(Rp)
CKPN (Rp)
2. EXPLANATION OF FORM 2200 (LIST OF DETAILED IJK RECEIVABLES)
FORM 2200 LIST OF DETAILED IJK RECEIVABLES contains details of IJK receivables from the Indonesian Government, both central and regional, in connection with guarantee business activities that are government assignment programs, such as the Guarantee program for People's Business Credit (KUR). Sharia Guarantee Companies and/or UUS that receive assignments from the government must prove this with evidence of assignment. The explanation is as follows:

No.
This field is filled with the row sequence in the form.
Name of Guarantor Recipient
This field is filled according to the name of the financial institution or non-financial institution that has provided financing or service contracts to the insured.
Type of Guarantee

This field is filled with the type of guarantee classified as follows:
a) Productive Credit Guarantee – MSME; b) Productive Credit Guarantee – Non-MSME; c) Other Guarantees – Guarantee over debt instruments; d) Other Guarantees – Guarantee for installment purchases; e) Other Guarantees – Guarantee for trade transactions; f) Other Guarantees – Guarantee for procurement of goods and/or services (surety bond); g) Other Guarantees – Guarantee for bank guarantees (contra bank guarantee); h) Other Guarantees – Guarantee for domestic documentary credits; i) Other Guarantees – Guarantee for letters of credit; j) Other Guarantees – Guarantee for customs (customs bond); k) Other Guarantees – Guarantee for excise; l) Other Guarantees – Provision of management consulting services related to guarantee business activities; m) Other Guarantees – Other business activities after obtaining approval from the Financial Services Authority; and n) Non-Productive Guarantee.
4) Guarantee Product
This field is filled with the name of the Sharia guarantee product owned by the Sharia guarantee company or UUS, for example Surety Bond Advance Payment Guarantee, KUKPEDES Guarantee (Rural Small Business Credit Guarantee), All-Purpose Credit Guarantee, Multi-Purpose Credit Guarantee, and others.
5) Insured Amount (Unit)
This field is filled with the insured amount guaranteed by the Sharia Guarantee Company or UUS.
6) Financing/Project Value
This field is filled with the financing amount or project value of the insured party.

Guarantee Value
This field is filled with the guarantee coverage value in accordance with the kafalah certificate.
Outstanding Guarantee
This field is filled with the outstanding guarantee value borne by the Sharia Guarantee Company or UUS.
IJK Receivable Value
This field is filled with the IJK receivable value from the Indonesian Government, both central and regional, in connection with guarantee business activities that are government assignment programs, such as the KUR guarantee program.
CKPN
This field is filled with the CKPN value in accordance with Financial Accounting Standards.

F. FORM 2300: LIST OF DETAILED CO-GUARANTEE AND REINSURANCE/RE-GUARANTEE RECEIVABLES

FORM 2300 FORMAT (LIST OF DETAILED CO-GUARANTEE AND REINSURANCE/RE-GUARANTEE RECEIVABLES)
FORM 2300: LIST OF DETAILED CO-GUARANTEE AND REINSURANCE/RE-GUARANTEE RECEIVABLES is prepared in the following format:

No. Name Kafalah Certificate Number
Kafalah Certificate Date
Type of
Guarantee
Product
Guarantee
Value
Credit/
Project
Value
Guarantee
Value
Guarantee
Value
Partner
Portion
1.
2.
3. etc.
10) 11) 12) 13) 14) 15) 16)
Name
Partner
Scheme Claim Amount
Claim Date
Claim Receivable
Number of Days
Overdue
CKPN
2. EXPLANATION OF FORM 2300 (LIST OF DETAILED CO-GUARANTEE/RE-GUARANTEE RECEIVABLES)
FORM 2300 LIST OF DETAILED CO-GUARANTEE AND REINSURANCE/RE-GUARANTEE RECEIVABLES contains details of receivables including details of receivables from co-guarantee partners or reinsurance or re-guarantee in connection with claim payments that are the responsibility of the partner, with the explanation as follows:

No.
This field is filled with the row sequence in the form.
Name
This field is filled with the name of the individual insured.
Kafalah Certificate Number
This field is filled with the kafalah certificate number underlying the guarantee agreement.
Kafalah Certificate Date
This field is filled with the date of the kafalah certificate underlying the guarantee agreement.
Type of Guarantee
This field is filled with the type of guarantee classified as follows:
a) Productive Credit Guarantee – MSME; b) Productive Credit Guarantee – Non-MSME; c) Other Guarantees – Guarantee over debt instruments; d) Other Guarantees – Guarantee for installment purchases; e) Other Guarantees – Guarantee for trade transactions; f) Other Guarantees – Guarantee for procurement of goods and/or services (surety bond); g) Other Guarantees – Guarantee for bank guarantees (contra bank guarantee); h) Other Guarantees – Guarantee for domestic documentary credits; i) Other Guarantees – Guarantee for letters of credit; j) Other Guarantees – Guarantee for customs (customs bond); k) Other Guarantees – Guarantee for excise; l) Other Guarantees – Provision of management consulting services related to guarantee business activities; m) Other Guarantees – Other business activities after obtaining approval from the Financial Services Authority; and

n) Non-Productive Guarantee.
6) Guarantee Product
This field is filled with the name of the Sharia guarantee product owned by the Sharia guarantee company or UUS, for example Surety Bond Advance Payment Guarantee, KUKPEDES Guarantee, All-Purpose Credit Guarantee, Multi-Purpose Credit Guarantee, and others.
7) Financing/Project Value
This field is filled with the financing value or project value that is guaranteed.
8) Guarantee Value
This field is filled with the guarantee value provided by the Sharia Guarantee Company or UUS
9) Partner Portion Guarantee Value
This field is filled with the guarantee value that is co-guaranteed, re-guaranteed, or reinsured.
10) Partner Name
This field is filled with the name of the co-guarantee/reinsurance/re-guarantee partner.
11) Scheme
This field is filled with the guarantee scheme, namely co-guarantee or reinsurance/re-guarantee.
12) Claim Amount
This field is filled with the claim value approved to be paid by the Sharia Guarantee Company or UUS to the guarantor recipient.
13) Claim Date
This field is filled with the date the claim is approved by the Sharia Guarantee Company or UUS.
14) Claim Receivable
This field is filled with the claim amount not yet paid by the co-guarantee/reinsurance/re-guarantee partner to the Sharia Guarantee Company or UUS.
15) Number of Days Overdue
This field is filled with the number of days of overdue claim payments to the leader with the co-guarantee guarantee mechanism.

CKPN
This field is filled with the CKPN value in accordance with applicable financial accounting standards.

G. FORM 2400: LIST OF DETAILED OTHER ASSETS

FORM 2400 FORMAT (LIST OF DETAILED OTHER ASSETS)
FORM 2400: LIST OF DETAILED OTHER ASSETS is prepared in the following format:

No. Description Current Assets (Rp) Non-Current Assets (Rp) 1.
2.
3. etc.
TOTAL
2. EXPLANATION OF FORM 2400 (LIST OF DETAILED OTHER ASSETS)
FORM 2400 LIST OF DETAILED OTHER ASSETS contains details of other assets that cannot be classified into the Asset accounts on the Statement of Financial Position, with the explanation as follows:

No.
This field is filled with the row sequence in the form.
Description
This field is filled with the components forming other assets.
Example: vehicles, land, and so on.
Current Assets (Rp)
This field is filled with the amount of components forming current assets calculated net.
Non-Current Assets (Rp)
This field is filled with the amount of components forming non-current assets calculated net.

H. FORM 2500: LIST OF DETAILED NET FIXED ASSETS

FORM 2500 FORMAT (LIST OF DETAILED NET FIXED ASSETS)
FORM 2500 LIST OF DETAILED NET FIXED ASSETS is prepared in the following format:

No. Description Nominal (Rp)
1.
2.
3. etc.
TOTAL
2. EXPLANATION OF FORM 2500 (LIST OF DETAILED NET FIXED ASSETS)
FORM 2500 LIST OF DETAILED NET FIXED ASSETS contains details of tangible assets owned by the Sharia Guarantee Company or UUS and used in operational activities in accordance with applicable financial accounting standards, with the explanation as follows:

No.
This field is filled with the row sequence in the form.
Description
This field is filled with the components forming fixed assets.
Example: vehicles, land, right-of-use lease assets, and so on.
Nominal (Rp)
This field is filled with the amount of components forming fixed assets calculated net.

I. FORM 2600: LIST OF DETAILED COMMISSION LIABILITIES

FORM 2600 FORMAT (LIST OF DETAILED COMMISSION LIABILITIES)

FORM 2600: DETAILED LIST OF COMMISSION DEBTS is prepared in the following format:

2) 3) 4) 5)
No. Guarantor Name
Guarantee
Type of Guarantee Guarantee Product Agent Name 1.

etc.

Commission Debt (Rp) Number of Days Overdue
(Unit)
2. EXPLANATION OF FORM 2600 (DETAILED LIST OF COMMISSION DEBTS)
FORM 2600 DETAILED LIST OF COMMISSION DEBTS contains details of commission debts to third parties in connection with the closure of guarantees, with the following explanations:

No.
This position is filled with the row sequence in the form.
Guarantor Name
This position is filled according to the name of a financial institution or non-financial institution that has provided credit, financing, or service contracts to the guaranteed party.
Type of Guarantee
This position is filled with the type of guarantee classified as follows:
a) Productive Credit Guarantee – MSMEs; b) Productive Credit Guarantee – Non-MSMEs; c) Other Guarantees – Guarantee over debt instruments; d) Other Guarantees – Installment purchase guarantee; e) Other Guarantees – Trade transaction guarantee; f) Other Guarantees – Procurement of goods and/or services guarantee (surety bond); g) Other Guarantees – Bank guarantee (counter bank guarantee); h) Other Guarantees – Domestic documentary credit guarantee; i) Other Guarantees – Letter of credit guarantee; j) Other Guarantees – Customs bond guarantee; k) Other Guarantees – Excise guarantee; l) Other Guarantees – Provision of management consulting services related to guarantee business activities; m) Other Guarantees – Other business activities after obtaining approval from the Financial Services Authority; and n) Non-Productive Guarantee.
Guarantee Product
This position is filled with the name of the Sharia guarantee product owned by the Sharia guarantee company or UUS, for example Surety Bond Advance Payment Guarantee, KUKPEDES Guarantee, All-Purpose Credit Guarantee, Multi-Purpose Credit Guarantee, and others.
Agent Name
This position is filled with the name of the broker or guarantee agent.
Commission Debt
This position is filled with the amount of commission debt to third parties in connection with the closure of guarantees.
Number of Days Overdue
This position is filled with the number of days of overdue commission payments up to the reporting period.

J. FORM 2700: DETAILED LIST OF CO-GUARANTEE CLAIM DEBTS

FORM 2700 FORMAT (DETAILED LIST OF CO-GUARANTEE CLAIM DEBTS)
FORM 2700: DETAILED LIST OF CO-GUARANTEE CLAIM DEBTS is prepared in the following format:

No. Guaranteed Name
Type of Guarantee
Product of Guarantee
Partner Company
Name
1.
2.
3. etc.
6) 7)
Claim Debt (Rp) Number of Days
Overdue
2. EXPLANATION OF FORM 2700 (DETAILED LIST OF CO-GUARANTEE CLAIM DEBTS)
FORM 2700 DETAILED LIST OF CO-GUARANTEE CLAIM DEBTS contains details of debts in co-guarantee guarantee efforts with co-guarantee partners, with the following explanations:

No.
This position is filled with the row sequence in the form.
Guaranteed Name
This position is filled with the name of the individual of the guaranteed party.
Type of Guarantee
This position is filled with the type of guarantee classified as follows:
a) Productive Credit Guarantee – MSMEs; b) Productive Credit Guarantee – Non-MSMEs; c) Other Guarantees – Guarantee over debt instruments; d) Other Guarantees – Installment purchase guarantee; e) Other Guarantees – Trade transaction guarantee; f) Other Guarantees – Procurement of goods and/or services guarantee (surety bond); g) Other Guarantees – Bank guarantee (counter bank guarantee); h) Other Guarantees – Domestic documentary credit guarantee; i) Other Guarantees – Letter of credit guarantee; j) Other Guarantees – Customs bond guarantee; k) Other Guarantees – Excise guarantee; l) Other Guarantees – Provision of management consulting services related to guarantee business activities; m) Other Guarantees – Other business activities after obtaining approval from the Financial Services Authority; and n) Non-Productive Guarantee.
Guarantee Product
This position is filled with the name of the Sharia guarantee product owned by the Sharia guarantee company or UUS, for example Surety Bond Advance Payment Guarantee, KUKPEDES Guarantee, All-Purpose Credit Guarantee, Multi-Purpose Credit Guarantee, and others.
Partner Company Name
This position is filled with the name of the partner company of the Sharia Guarantee Company or UUS and the Guarantee Institution.
Claim Debt
This position is filled with the amount of claims that have not been paid to the partner company.
Number of Days Overdue
This position is filled with the number of days of overdue claim payments to the leader in connection with the co-guarantee guarantee mechanism.

K. FORM 2800: DETAILED LIST OF IJK DEBTS FOR CO-GUARANTEE AND SHARIA REINSURANCE/SHARIA RE-GUARANTEE

FORM 2800 FORMAT (DETAILED LIST OF IJK DEBTS FOR CO-GUARANTEE AND SHARIA REINSURANCE/SHARIA RE-GUARANTEE)
FORM 2800 DETAILED LIST OF IJK DEBTS FOR CO-GUARANTEE AND SHARIA REINSURANCE/SHARIA RE-GUARANTEE is prepared in the following format:
1). 2). 3). 4). 5). 6). 7).
No. Scheme Name National Identity Number
(NIK)/Taxpayer Identification Number
(TPIN)
Gender
Certificate
Number
Kafalah
Date
Kafalah Certificate
etc.
8). 9). 10). 11). 12).
Type
Guarantee
Recipient
Name
Guarantee
Recipient
Type
Sharia
Guarantee
Product
Sharia
Guarantee
Guaranteed Location a. Regency/City b. Province 13). 14). 15). 16). 17). 18).
Economic Sector Financing Value/
Project
Guarantee
Value
CoGuarantee Value/
Reinsurance
Outstanding
Sharia
Guarantee
Own Retention
Date
Start of Guarantee

19). 20). 21). 22). 23).
End Date of Guarantee Number of Days
IJK Debt
IJK Value
IJK Debt CKPN
2. EXPLANATION OF FORM 2800 (DETAILED LIST OF IJK DEBTS FOR CO-GUARANTEE AND SHARIA REINSURANCE/SHARIA RE-GUARANTEE)
FORM 2800 DETAILED LIST OF IJK DEBTS FOR CO-GUARANTEE AND SHARIA REINSURANCE/SHARIA RE-GUARANTEE contains details of debts that must be paid by the Sharia Guarantee Company or UUS to transfer claim risks, with the following explanations:

No.
This position is filled with the row sequence in the form.
Scheme
This position is filled with the guarantee scheme, namely co-guarantee or Sharia reinsurance/Sharia re-guarantee. Name This position is filled with the name of the individual of the guaranteed party.
Name
This position is filled with the name of the individual of the guaranteed party.
National Identity Number (NIK)/Taxpayer Identification Number (TPIN)
This position is filled with the NIK of the guaranteed party and the TPIN of the guaranteed party that is a legal entity.
Gender
This position is filled with the gender of the guaranteed party. Fill “L” for guaranteed parties with male gender and “P” for guaranteed parties with female gender.
Certificate Number Kafalah
This position is filled with the kafalah certificate number underlying the guarantee agreement.
Date of Kafalah Certificate
This position is filled with the date of the kafalah certificate underlying the guarantee agreement.
Type of Guarantee Recipient
This position is filled with “Bank”, “Non-Bank Financial Institution”, or “Surety”.
Name of Guarantee Recipient
This position is filled according to the definition of the name of a financial institution or non-financial institution that has provided financing, and financing or service contracts to the guaranteed party.
Type of Sharia Guarantee
This position is filled with the type of guarantee classified as follows:
a) Productive Credit Guarantee – MSMEs; b) Productive Credit Guarantee – Non-MSMEs; c) Other Guarantees – Guarantee over debt instruments; d) Other Guarantees – Installment purchase guarantee; e) Other Guarantees – Trade transaction guarantee; f) Other Guarantees – Procurement of goods and/or services guarantee (surety bond); g) Other Guarantees – Bank guarantee (counter bank guarantee); h) Other Guarantees – Domestic documentary credit guarantee; i) Other Guarantees – Letter of credit guarantee; j) Other Guarantees – Customs bond guarantee; k) Other Guarantees – Excise guarantee; l) Other Guarantees – Provision of management consulting services related to guarantee business activities;

m) Other Guarantees – Other business activities after obtaining approval from the Financial Services Authority; and n) Non-Productive Guarantee.
11) Product of Sharia Guarantee
This position is filled with the name of the Sharia guarantee product owned by the Sharia guarantee company or UUS, for example Surety Bond Advance Payment Guarantee, KUKPEDES Guarantee, All-Purpose Credit Guarantee, Multi-Purpose Credit Guarantee, and others.
12) Guaranteed Location
a. Regency/City
This position is filled with the regency/city of the guaranteed party's domicile area. b. Province This position is filled with the province of the guaranteed party's domicile area.
13) Economic Sector
This position is filled with the sector of the guaranteed party based on the classification in the Regulation of the Central Bureau of Statistics regarding the Standard Indonesian Business Field Classification.
14) Financing Value/Project
This position is filled with the financing value or project value that is guaranteed.
15) Value of Sharia Guarantee
This position is filled with the value of the Sharia guarantee provided by the Sharia Guarantee Company or UUS.
16) Value of Co-Guarantee /Sharia Reinsurance
This position is filled with the value of the Sharia guarantee that is reinsured or re-guaranteed.
17) Outstanding Sharia Guarantee Own Retention
This position is filled with the value of outstanding guarantees covered by the Sharia Guarantee Company or UUS.
18) Date of Start of Sharia Guarantee
This position is filled with the start date of the Sharia guarantee in accordance with the kafalah certificate.

End Date of Guarantee
This position is filled with the end date of the Sharia guarantee in accordance with the kafalah certificate.
Number of Days of IJK Debt
This position is filled with the number of days of unpaid IJK debt.
IJK Value
This position is filled with the IJK value to be provided by the Sharia Guarantee Company or UUS in connection with Sharia guarantee business activities.
IJK Debt
This position is filled with the IJK debt for co-guarantee or Sharia re-guarantee/Sharia reinsurance that must be paid by the Sharia Guarantee Company or UUS to the Sharia re-guarantee/Sharia reinsurance partner.
CKPN
This position is filled with the CKPN value in accordance with applicable financial accounting standards.

L. FORM 2900: DETAILED LIST OF OTHER LIABILITIES

FORM 2900 FORMAT (DETAILED LIST OF OTHER LIABILITIES)
FORM 2900 DETAILED LIST OF OTHER LIABILITIES is prepared in the following format:

No. Description Current Liabilities (Rp) Non-Current Liabilities (Rp) 1.
2.
3. etc.
TOTAL
2. EXPLANATION OF FORM 2900: DETAILED LIST OF OTHER LIABILITIES
FORM 2900 DETAILED LIST OF OTHER LIABILITIES contains details of other liabilities that cannot be classified into the Liability accounts in the Statement of Financial Position, with the following explanations:

No.
This position is filled with the row sequence in the form.
Description
This position is filled with the components forming other liabilities.
Current Liabilities (Rp)
This position is filled with the amount of components forming current liabilities calculated net.
Non-Current Liabilities (Rp)
This position is filled with the amount of components forming non-current liabilities calculated net.

M. FORM 3000: DETAILED LIST OF MANDATORY CONVERSION BONDS

FORM 3000 FORMAT (DETAILED LIST OF MANDATORY CONVERSION BONDS)
FORM 3000 DETAILED LIST OF MANDATORY CONVERSION BONDS is prepared in the following format:

No
Name
Sharia Bond
Nominal Premium/
Discount
Yield
Rate
Duration i.
Start ii.
Maturity iii.
Tenor
1.
2.
3. etc.
Total
2. EXPLANATION OF FORM 3000 (DETAILED LIST OF MANDATORY CONVERSION BONDS)
FORM 3000 DETAILED LIST OF MANDATORY CONVERSION BONDS contains details of bonds issued by the Sharia Guarantee Company or UUS that must be converted into shares based on an agreement between the Sharia Guarantee Company or UUS and the bondholders, with the following explanations:

No.
This position is filled with the row sequence in the form.
Bond Name
This position is filled with the name of the mandatory conversion bond.
Nominal
This position is filled with the investment amount.
Premium/Discount
This position is filled with the discount or interest that must be paid by the Sharia Guarantee Company or UUS.
Yield Rate
This position is filled with the bond yield rate.
Duration
i. Start
This position is filled with the date, month, and year of the start of fund placement in the form of Sharia bonds.

ii. Maturity
This position is filled with the date, month, and year of the maturity of the Sharia bond.
iii. Tenor
This position is filled with the duration of the Sharia bond.

N. FORM 3100: DETAILED LIST OF SHARIA GUARANTEES

FORM 3100 FORMAT (DETAILED LIST OF SHARIA GUARANTEES)
FORM 3100 DETAILED LIST OF SHARIA GUARANTEES is prepared in the following format:
1). 2). 3). 4). 5). 6). 7).
No. Number
Kafalah
Certificate
Date
Kafalah
Certificate
Name
Guaranteed
NIK/
TPIN
Sector
Economy
Type of Guarantee
etc.
8). 9). 10). 11). 12). 13). 14).
Product
Guarantee
Name
Recipient
Guarantee
Date
Start of Guarantee
Date
End of Guarantee
Value
Financing/Facilit y
Value
Guarantee
Value
IJK
15). 16). 17). 18). 19).
Value IJK Portion
Sharia Guarantee
Company
Value IJK Re-Guarantee/Contribution
Reinsurance
Acquisition
Cost
Value
Guarantee
Covered
Own
Value
Guarantee
Portion Partner
Re-Guarantee/Reinsuran ce
EXPLANATION OF FORM 3100 (DETAILED LIST OF SHARIA GUARANTEES)
FORM 3100 DETAILED LIST OF SHARIA GUARANTEES contains details of guarantees that are still ongoing in the reporting period (outstanding Sharia guarantees), with the following explanations:

No.
This position is filled with the sequence number in the form row.
Number of Kafalah Certificate
This position is filled with the kafalah certificate number underlying the Sharia guarantee agreement.
Date of Kafalah Certificate
This position is filled with the date of the kafalah certificate underlying the Sharia guarantee agreement.
Name of Guaranteed Party
This position is filled with the name of the individual of the guaranteed party.
NIK/TPIN
This position is filled with the NIK of the guaranteed party and the TPIN of the guaranteed party that is a legal entity.
Economic Sector
This position is filled with the sector of the guaranteed party based on the classification in the Regulation of the Central Bureau of Statistics regarding the Standard Indonesian Business Field Classification.
Type of Sharia Guarantee
This position is filled with the type of guarantee classified as follows:
a) Productive Credit Guarantee – MSMEs; b) Productive Credit Guarantee – Non-MSMEs; c) Other Guarantees – Guarantee over debt instruments; d) Other Guarantees – Installment purchase guarantee; e) Other Guarantees – Trade transaction guarantee; f) Other Guarantees – Procurement of goods and/or services guarantee (surety bond); g) Other Guarantees – Bank guarantee (counter bank guarantee); h) Other Guarantees – Domestic documentary credit guarantee; i) Other Guarantees – Letter of credit guarantee;

j) Other Guarantees – Customs bond guarantee; k) Other Guarantees – Excise guarantee; l) Other Guarantees – Provision of management consulting services related to guarantee business activities; m) Other Guarantees – Other business activities after obtaining approval from the Financial Services Authority; and n) Non-Productive Guarantee.
8) Product of Sharia Guarantee
This position is filled with the name of the guarantee product owned by the guarantee company, for example Surety Bond Advance Payment Guarantee, KUKPEDES Guarantee, All-Purpose Credit Guarantee, Multi-Purpose Credit Guarantee, and others.
9) Name of Guarantee Recipient
This position is filled according to the name of a financial institution or non-financial institution that has provided credit, and financing or service contracts to the guaranteed party.
10) Date of Start of Sharia Guarantee
This position is filled with the start date of the Sharia guarantee in accordance with the guarantee certificate.
11) End Date of Guarantee
This position is filled with the end date of the guarantee in accordance with the guarantee certificate.
12) Financing/Facility Value
This position is filled with the amount of financing received by the guaranteed party from the financing-disbursing financial institution in connection with the financing guarantee or filled with the amount of facilities received by the guaranteed party in connection with the non-financing guarantee.
13) Guarantee Value
This position is filled with the agreed guarantee value to be guaranteed based on the financing/facility value of the guaranteed party as stated in the guarantee certificate.

IJK Value
This position is filled with the value of the guarantee service remuneration received by the Sharia Guarantee Company or UUS as stated in the guarantee certificate.
IJK Value Portion of Sharia Guarantee Company
This position is filled with the value of the kafalah service remuneration stated in the guarantee certificate which is the portion of the Sharia Guarantee Company or UUS, excluding the kafalah service remuneration which is the portion of the Sharia re-guarantee/Sharia reinsurance partner.
IJK Value of Re-Guarantee/Reinsurance Contribution
This position is filled with the portion of the kafalah service remuneration stated in the guarantee certificate which is the portion of the partner company of the Sharia re-guarantee/Sharia reinsurance.
Acquisition Cost
This position is filled with the costs paid by the Sharia Guarantee Company or UUS in the context of business acquisition. Example: commission to the guarantee agent and fee-based income to the guarantee recipient.
Value of Guarantee Covered Own
This position is filled with the value of outstanding guarantees covered (own retention) by the Sharia Guarantee Company or UUS.
Value of Guarantee Portion of Partner Sharia Re-Guarantee/Sharia Reinsurance
This position is filled with the value of outstanding guarantees covered by the Partner Sharia Re-Guarantee/Sharia Reinsurance.

O. FORM 3200: DETAILED LIST OF SHARIA GUARANTEE CLAIM REPORT PER GUARANTEED LOCATION

FORM 3200 FORMAT (DETAILED LIST OF SHARIA GUARANTEE CLAIM REPORT PER GUARANTEED LOCATION)
FORM 3200 DETAILED LIST OF SHARIA GUARANTEE CLAIM REPORT PER GUARANTEED LOCATION is prepared in the following format:
a. Financing Guarantee

No. Guaranteed Location (Province)
Productive Financing Guarantee
–
MSME Financing Guarantee
(Non KUR) a) Number
Guaranteed
(Unit) b) Value
Guarantee
(Rp) c) Value
Claim
(Rp)
4) 5)
Productive Financing Guarantee
–
Non-MSME
Micro Business Financing Guarantee
Non-Productive Financing Guarantee a) Number
Guaranteed
(Unit) b) Value
Guarantee
(Rp) c) Value
Claim
(Rp) a) Number
Guaranteed
(Unit) b) Value
Guarantee
(Rp) c) Value
Claim
(Rp)
6) 7)
KUR Guarantee -
Micro
KUR Guarantee -
Non-Micro a) Number
Guaranteed
(Unit) b) Value
Guarantee
(Rp) c) Value
Claim
(Rp) a) Number
Guaranteed
(Unit) b) Value
Guarantee
(Rp) c) Value
Claim
(Rp)
8)
Total a) Number
Guaranteed
(Unit) b) Value
Guarantee
(Rp) c) Value
Claim
(Rp)

b. Other Guarantees

2) 3)
No.
Location
Guaranteed
(Province)
Guarantee over Debt Instruments a) Number
Guaranteed
(Unit) b) Value
Guarantee
(Rp) c) Claim Value (Rp)

Guarantee for Purchase of Goods in Installments Guarantee for Trade Transactions a) Number Guaranteed (Unit) b) Value Guarantee (Rp) c) Value Claim (Rp) a) Number Guaranteed (Unit) b) Value Guarantee (Rp) c) Value Claim (Rp)
6) 7)
Guarantee for Procurement of goods and/or Services (Surety Bond) Bank Guarantee (Counter Bank Guarantee) a) Number Guaranteed (Unit) b) Value Guarantee (Rp) c) Value Claim (Rp) a) Number Guaranteed (Unit) b) Value Guarantee (Rp) c) Value Claim (Rp)
8) 9)
Domestic Documentary Credit
Guarantee Letter of Credit Guarantee a) Number Guaranteed (Unit) b) Value Guarantee (Rp) c) Value Claim (Rp) a) Number Guaranteed (Unit) b) Value Guarantee (Rp) c) Value Claim (Rp)

Customs Bond
Guarantee Excise Guarantee a) Number
Guaranteed
(Unit) b) Value
Guarantee
(Rp) c) Value
Claim
(Rp) a) Number
Guaranteed
(Unit) b) Value
Guarantee
(Rp) c) Value
Claim
(Rp)
12) 13)
Provision of Management Consulting
Services related to
Guarantee Business Activities
Other Business Activities after
Obtaining Approval from the Financial
Services Authority a) Number
Guaranteed
(Unit) b) Value
Guarantee
(Rp) c) Value
Claim
(Rp) a) Number
Guaranteed
(Unit) b) Value
Guarantee
(Rp) c) Value
Claim
(Rp)
14)
Total a) Number
Guaranteed
(Unit) b) Value
Guarantee
(Rp) c) Value
Claim
(Rp)
2. FORM 3200 FORMAT (DETAILED LIST OF SHARIA GUARANTEE CLAIM REPORT PER GUARANTEED LOCATION)
FORM 3200 DETAILED LIST OF SHARIA GUARANTEE CLAIM REPORT PER GUARANTEED LOCATION contains a report of guarantee claims based on the location of the guaranteed party, with the following explanations:
a. Financing Guarantee

No.
This position is filled with the sequence number in the form row.
Guaranteed Location (Province)
This position is filled with the administrative province area where the guaranteed party is located.
Productive Financing Guarantee – MSME Financing Guarantee (Non KUR)
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Value Guarantee (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Value Claim (Rp) This position is filled with the value of claims paid by the Sharia Guarantee Company or UUS for the current year.
Productive Financing Guarantee – Non-MSME Micro Business Financing Guarantee
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Value Guarantee (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Value Claim (Rp) This position is filled with the value of claims paid by the Sharia Guarantee Company or UUS for the current year.
Non-Productive Financing Guarantee
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Value Guarantee (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year.

c) Value Claim (Rp)
This position is filled with the value of claims paid by the Sharia Guarantee Company or UUS for the current year.
6) KUR Guarantee – Micro
a) Number Guaranteed (Unit)
This position is filled with the number of KUR Super Micro and KUR Micro guaranteed parties in outstanding guarantees for the current year. b) Value Guarantee (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Value Claim (Rp) This position is filled with the value of claims paid by the Sharia Guarantee Company or UUS for the current year.
7) KUR Guarantee – Non-Micro
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Value Guarantee (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Value Claim (Rp) This position is filled with the value of claims paid by the Sharia Guarantee Company or UUS for the current year.
8) Total
a) Number Guaranteed (Unit)
This position is filled with the number of guaranteed parties in outstanding guarantees for the current year. b) Value Guarantee (Rp)

This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year. b. Other Guarantees

No.
This position is filled with the sequence number in the form row.
Guaranteed Location (Province)
This position is filled with the provincial administrative region where the guaranteed party is located.
Guarantee on Debt Instruments
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Installment Goods Purchase Guarantee
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Trade Transaction Guarantee
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Goods and/or Services Procurement Guarantee (Surety Bond)
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Bank Guarantee Guarantee (Counter Bank Guarantee)
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Domestic Documentary Credit Guarantee
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Letter of Credit Guarantee
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Customs Bond Guarantee
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Excise Guarantee
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Management Consulting Services Related to the Guarantor's Business Activities
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Other Business Activities after Receiving Approval from the Financial Services Authority
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Total
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.

P. FORM 3300: DETAIL LIST OF SHARIA GUARANTEE CLAIM REPORT PER GUARANTEE RECIPIENT

FORM 3300 SHAPE (DETAIL LIST OF SHARIA GUARANTEE CLAIM REPORT PER GUARANTEE RECIPIENT)
FORM 3300 DETAIL LIST OF SHARIA GUARANTEE CLAIM REPORT PER GUARANTEE RECIPIENT is arranged in the following format:
a. Financing Guarantees

No. Guarantee Recipient Location
(Province)
Productive Financing Guarantee –
MSME Financing Guarantee
(Non KUR) a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp)
4) 5)
Productive Financing Guarantee –
Non-MSME Micro Business
Financing Guarantee
Non-Productive Financing
Guarantee a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp) a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp)
6) 7)
KUR Guarantee -
Micro
KUR Guarantee -
Non-Micro a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp) a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp)
8)
Total a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp) b. Other Guarantees

2) 3)
No.
Guarantee
Recipient
Location
(Province)
Guarantee on Debt Instruments a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim Value (Rp)

Installment Goods
Purchase Guarantee Trade Transaction
Guarantee a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp) a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp)
6) 7)
Goods and/or Services
Procurement Guarantee (Surety Bond)
Bank Guarantee Guarantee (Counter
Bank Guarantee) a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp) a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp)
8) 9)
Domestic Documentary
Credit Guarantee Letter of Credit
Guarantee a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp) a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp)
10) 11)
Customs Bond
Guarantee Excise
Guarantee a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp) a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp)
12) 13)
Provision of Management
Consulting Services related to
Guarantor's Business Activities
Other Business Activities after
Receiving Approval from the Financial
Services Authority a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp) a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp)
14)
Total a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp)
2. FORM 3300 EXPLANATION (DETAIL LIST OF SHARIA GUARANTEE CLAIM REPORT PER GUARANTEE RECIPIENT LOCATION)
FORM 3300 DETAIL LIST OF SHARIA GUARANTEE CLAIM REPORT PER GUARANTEE RECIPIENT LOCATION contains a guarantee claim report based on the guarantee recipient's location, with the following explanation:
a. Financing Guarantees

No.
This position is filled with the sequence number in the form row.
Guarantee Recipient Location (Province)
This position is filled with the provincial administrative region where the guarantee recipient is located.
Productive Financing Guarantee – MSME Financing Guarantee (Non KUR)
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Productive Financing Guarantee – Non-MSME Micro Business Financing Guarantee
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Non-Productive Financing Guarantee
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
KUR Guarantee – Micro
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount of KUR Super Micro and KUR Micro in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
KUR Guarantee – Non-Micro
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Total
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year. b. Other Guarantees
No.
This position is filled with the sequence number in the form row.
Guarantee Recipient Location (Province)
This position is filled with the provincial administrative region where the guarantee recipient is located.
Guarantee on Debt Instruments
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Installment Goods Purchase Guarantee
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Trade Transaction Guarantee
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Goods and/or Services Procurement Guarantee (Surety Bond)
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Bank Guarantee Guarantee (Counter Bank Guarantee)
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Domestic Documentary Credit Guarantee
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Letter of Credit Guarantee
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Customs Bond Guarantee
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Excise Guarantee
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Management Consulting Services Related to the Guarantor's Business Activities
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Other Business Activities after Receiving Approval from the Financial Services Authority
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Total
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.

Q. FORM 3400: DETAIL LIST OF SHARIA GUARANTEE CLAIM REPORT PER ECONOMIC SECTOR

FORM 3400 SHAPE (DETAIL LIST OF SHARIA GUARANTEE CLAIM REPORT PER ECONOMIC SECTOR)
FORM 3400 DETAIL LIST OF SHARIA GUARANTEE CLAIM REPORT PER ECONOMIC SECTOR is arranged in the following format:
a. Financing Guarantees

No. Economic Sector
Productive Financing Guarantee –
MSME Financing Guarantee
(Non KUR) a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp)
4) 5)
Productive Financing Guarantee –
Non-MSME Micro Business
Financing Guarantee
Non-Productive Financing
Guarantee a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp) a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp)
6) 7)
KUR Guarantee -
Micro
KUR Guarantee -
Non-Micro a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp) a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp)
8)
Total a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp) b. Other Guarantees

2) 3)
No. Economic
Sector
Guarantee on Debt Instruments a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim Value (Rp)

Installment Goods
Purchase Guarantee Trade Transaction
Guarantee a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp) a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp)
6) 7)
Goods and/or Services
Procurement Guarantee (Surety Bond)
Bank Guarantee Guarantee (Counter
Bank Guarantee) a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp) a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp)
8) 9)
Domestic Documentary
Credit Guarantee Letter of Credit
Guarantee a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp) a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp)
10) 11)
Customs Bond
Guarantee Excise
Guarantee a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp) a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp)
12) 13)
Provision of Management
Consulting Services related to
Guarantor's Business Activities
Other Business Activities after
Receiving Approval from the Financial
Services Authority a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp) a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp)
14)
Total a) Guaranteed
Amount
(Unit) b) Guarantee
Value
(Rp) c) Claim
Value
(Rp)
2. FORM 3400 EXPLANATION (DETAIL LIST OF SHARIA GUARANTEE CLAIM REPORT PER ECONOMIC SECTOR)
FORM 3400 DETAIL LIST OF SHARIA GUARANTEE CLAIM REPORT PER ECONOMIC SECTOR contains a guarantee claim report based on the guaranteed economic sector, with the following explanation:
a. Financing Guarantees

No.
This position is filled with the sequence number in the form row.
Economic Sector
This position is filled with the sector of the guaranteed party based on the classification in the Regulation of the Central Bureau of Statistics regarding the Standard Indonesian Business Field Classification.
Productive Financing Guarantee – MSME Financing Guarantee (Non KUR)
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Productive Financing Guarantee – Non-MSME Micro Business Financing Guarantee
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Non-Productive Financing Guarantee
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
KUR Guarantee – Micro
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount of KUR Super Micro and KUR Micro in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
KUR Guarantee – Non-Micro
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year.
Total
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year. c) Claim Value (Rp) This position is filled with the claim value paid by the Sharia Guarantee Company or UUS for the current year. b. Other Guarantees
No.
This position is filled with the sequence number in the form row.
Economic Sector
This position is filled with the sector of the guaranteed party based on the classification in the Regulation of the Central Bureau of Statistics regarding the Standard Indonesian Business Field Classification.
Guarantee on Debt Instruments
a) Guaranteed Amount (Unit)
This position is filled with the guaranteed amount in outstanding guarantees for the current year. b) Guarantee Value (Rp) This position is filled with the guarantee ceiling provided by the Sharia Guarantee Company or UUS for the current year.

c) Claim Value (Rp)
This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year.

Guarantee for Installment Purchase of Goods
a) Guaranteed Amount (Unit)
This field is filled with the guaranteed amount in outstanding guarantees per current year. b) Guarantee Value (Rp) This field is filled with the guarantee ceiling provided by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Value (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
Guarantee for Trade Transactions
a) Guaranteed Amount (Unit)
This field is filled with the guaranteed amount in outstanding guarantees per current year. b) Guarantee Value (Rp) This field is filled with the guarantee ceiling provided by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Value (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
Guarantee for Procurement of Goods and/or Services (Surety Bond)
a) Guaranteed Amount (Unit)
This field is filled with the guaranteed amount in outstanding guarantees per current year. b) Guarantee Value (Rp) This field is filled with the guarantee ceiling provided by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Value (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
Bank Guarantee Guarantee (Counter Bank Guarantee)
a) Guaranteed Amount (Unit)
This field is filled with the guaranteed amount in outstanding guarantees per current year. b) Guarantee Value (Rp) This field is filled with the guarantee ceiling provided by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Value (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
Domestic Documentary Credit Guarantee
a) Guaranteed Amount (Unit)
This field is filled with the guaranteed amount in outstanding guarantees per current year. b) Guarantee Value (Rp) This field is filled with the guarantee ceiling provided by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Value (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
Letter of Credit Guarantee
a) Guaranteed Amount (Unit)
This field is filled with the guaranteed amount in outstanding guarantees per current year. b) Guarantee Value (Rp) This field is filled with the guarantee ceiling provided by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Value (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
Customs Bond Guarantee
a) Guaranteed Amount (Unit)
This field is filled with the guaranteed amount in outstanding guarantees per current year. b) Guarantee Value (Rp) This field is filled with the guarantee ceiling provided by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Value (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
Excise Guarantee
a) Guaranteed Amount (Unit)
This field is filled with the guaranteed amount in outstanding guarantees per current year. b) Guarantee Value (Rp) This field is filled with the guarantee ceiling provided by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Value (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
Management Consulting Services Related to Guarantor's Business Activities
a) Guaranteed Amount (Unit)
This field is filled with the guaranteed amount in outstanding guarantees per current year. b) Guarantee Value (Rp) This field is filled with the guarantee ceiling provided by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Value (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
Other Business Activities after Obtaining Approval from the Financial Services Authority
a) Guaranteed Amount (Unit)
This field is filled with the guaranteed amount in outstanding guarantees per current year. b) Guarantee Value (Rp) This field is filled with the guarantee ceiling provided by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Value (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
Total
a) Guaranteed Amount (Unit)
This field is filled with the guaranteed amount in outstanding guarantees per current year. b) Guarantee Value (Rp) This field is filled with the guarantee ceiling provided by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Value (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year.

R. FORM 3500: LIST OF DETAILS OF SHARIA GUARANTEE CLAIM REPORT PER CLAIM STATUS

FORM 3500 FORMAT (LIST OF DETAILS OF SHARIA GUARANTEE CLAIM REPORT PER CLAIM STATUS)
FORM 3500 LIST OF DETAILS OF SHARIA GUARANTEE CLAIM REPORT PER CLAIM STATUS is structured according to the following format:

a. Financing Guarantee

2) 3)
No. Guarantee Recipient
Financing Guarantee - Productive Financing Guarantee - SME Financing Guarantee (Non KUR) a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp) 1 Bank 2 Non-Bank Financial Institution 3 Outside Financial Institution Total
Financing Guarantee - Productive Financing Guarantee - Non-SME Micro Business Financing
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Non-Productive Financing Guarantee
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
KUR Guarantee - Micro
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
KUR Guarantee - Non-Micro
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Total
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)

b. Other Guarantees

2) 3)
No.
Guarantee Recipient
Guarantee on Debt Instruments a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp) 1 Bank 2 Non-Bank Financial Institution 3 Outside Financial Institution Total
Guarantee for Installment Purchase of Goods
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Guarantee for Trade Transactions
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Guarantee for Procurement of Goods and/or Services (Surety Bond)
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Bank Guarantee Guarantee (Counter Bank Guarantee)
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Domestic Documentary Credit Guarantee
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Letter of Credit Guarantee
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Customs Bond Guarantee
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Excise Guarantee
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Provision of Management Consulting Services Related to Guarantor's Business Activities
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Other Business Activities after Obtaining Approval from the Financial Services Authority
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)
Total
a) Claim Submission (Rp) b) Claim Processed (Rp) c) Claim Approved (Rp) d) Claim Paid (Rp) e) Claim Rejected (Rp) f) Claim Approved But Not Yet Paid (Rp)

FORM 3500 EXPLANATION (LIST OF DETAILS OF SHARIA GUARANTEE CLAIM REPORT PER CLAIM STATUS)
FORM 3500 LIST OF DETAILS OF SHARIA GUARANTEE CLAIM REPORT PER CLAIM STATUS contains a report on guarantee claims based on claim status, with the following explanations:

a. Financing Guarantee

No.
This field is filled with the sequence number in the form row.
Guarantee Recipient
This field is filled with the type of guarantee recipient, namely "Bank", "Non-Bank Financial Institution", and "Outside Financial Institution".
Financing Guarantee - Productive Financing Guarantee - SME Financing Guarantee (Non KUR)
a) Claim Submission (Rp)
This field is filled with the claim value submitted to the Sharia Guarantee Company or Sharia Business Unit per current year. b) Claim Processed (Rp) This field is filled with the claim value currently being processed by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Approved (Rp) This field is filled with the claim value approved by the Sharia Guarantee Company or Sharia Business Unit per current year. d) Claim Paid (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year. e) Claim Rejected (Rp) This field is filled with the claim value rejected by the Sharia Guarantee Company or Sharia Business Unit per current year. f) Claim Approved But Not Yet Paid (Rp) This field is filled with the claim value approved but not yet paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
Financing Guarantee - Productive Financing Guarantee - Non-SME Micro Business Financing
a) Claim Submission (Rp)
This field is filled with the claim value submitted to the Sharia Guarantee Company or Sharia Business Unit per current year. b) Claim Processed (Rp) This field is filled with the claim value currently being processed by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Approved (Rp) This field is filled with the claim value approved by the Sharia Guarantee Company or Sharia Business Unit per current year. d) Claim Paid (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year. e) Claim Rejected (Rp) This field is filled with the claim value rejected by the Sharia Guarantee Company or Sharia Business Unit per current year. f) Claim Approved But Not Yet Paid (Rp) This field is filled with the claim value approved but not yet paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
Non-Productive Financing Guarantee
a) Claim Submission (Rp)
This field is filled with the claim value submitted to the Sharia Guarantee Company or Sharia Business Unit per current year. b) Claim Processed (Rp) This field is filled with the claim value currently being processed by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Approved (Rp) This field is filled with the claim value approved by the Sharia Guarantee Company or Sharia Business Unit per current year. d) Claim Paid (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year. e) Claim Rejected (Rp) This field is filled with the claim value rejected by the Sharia Guarantee Company or Sharia Business Unit per current year. f) Claim Approved But Not Yet Paid (Rp) This field is filled with the claim value approved but not yet paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
KUR Guarantee - Micro
a) Claim Submission (Rp)
This field is filled with the claim value submitted to the Sharia Guarantee Company or Sharia Business Unit per current year. b) Claim Processed (Rp) This field is filled with the claim value currently being processed by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Approved (Rp) This field is filled with the claim value approved by the Sharia Guarantee Company or Sharia Business Unit per current year. d) Claim Paid (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year. e) Claim Rejected (Rp) This field is filled with the claim value rejected by the Sharia Guarantee Company or Sharia Business Unit per current year. f) Claim Approved But Not Yet Paid (Rp) This field is filled with the claim value approved but not yet paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
KUR Guarantee - Non-Micro
a) Claim Submission (Rp)
This field is filled with the claim value submitted to the Sharia Guarantee Company or Sharia Business Unit per current year. b) Claim Processed (Rp) This field is filled with the claim value currently being processed by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Approved (Rp) This field is filled with the claim value approved by the Sharia Guarantee Company or Sharia Business Unit per current year. d) Claim Paid (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year. e) Claim Rejected (Rp) This field is filled with the claim value rejected by the Sharia Guarantee Company or Sharia Business Unit per current year. f) Claim Approved But Not Yet Paid (Rp) This field is filled with the claim value approved but not yet paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
Total
a) Claim Submission (Rp)
This field is filled with the claim value submitted to the Sharia Guarantee Company or Sharia Business Unit per current year. b) Claim Processed (Rp) This field is filled with the claim value currently being processed by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Approved (Rp) This field is filled with the claim value approved by the Sharia Guarantee Company or Sharia Business Unit per current year. d) Claim Paid (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year. e) Claim Rejected (Rp) This field is filled with the claim value rejected by the Sharia Guarantee Company or Sharia Business Unit per current year. f) Claim Approved But Not Yet Paid (Rp) This field is filled with the claim value approved but not yet paid by the Sharia Guarantee Company or Sharia Business Unit per current year.

b. Other Guarantees

No.
This field is filled with the sequence number in the form row.
Guarantee Recipient
This field is filled with the type of guarantee recipient, namely "Bank", "Non-Bank Financial Institution", and "Outside Financial Institution".
Guarantee on Debt Instruments
a) Claim Submission (Rp)
This field is filled with the claim value submitted to the Sharia Guarantee Company or Sharia Business Unit per current year. b) Claim Processed (Rp) This field is filled with the claim value currently being processed by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Approved (Rp) This field is filled with the claim value approved by the Sharia Guarantee Company or Sharia Business Unit per current year. d) Claim Paid (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year. e) Claim Rejected (Rp) This field is filled with the claim value rejected by the Sharia Guarantee Company or Sharia Business Unit per current year. f) Claim Approved But Not Yet Paid (Rp) This field is filled with the claim value approved but not yet paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
Guarantee for Installment Purchase of Goods
a) Claim Submission (Rp)
This field is filled with the claim value submitted to the Sharia Guarantee Company or Sharia Business Unit per current year. b) Claim Processed (Rp) This field is filled with the claim value currently being processed by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Approved (Rp) This field is filled with the claim value approved by the Sharia Guarantee Company or Sharia Business Unit per current year. d) Claim Paid (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year. e) Claim Rejected (Rp) This field is filled with the claim value rejected by the Sharia Guarantee Company or Sharia Business Unit per current year. f) Claim Approved But Not Yet Paid (Rp) This field is filled with the claim value approved but not yet paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
Guarantee for Trade Transactions
a) Claim Submission (Rp)
This field is filled with the claim value submitted to the Sharia Guarantee Company or Sharia Business Unit per current year. b) Claim Processed (Rp) This field is filled with the claim value currently being processed by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Approved (Rp) This field is filled with the claim value approved by the Sharia Guarantee Company or Sharia Business Unit per current year. d) Claim Paid (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year. e) Claim Rejected (Rp) This field is filled with the claim value rejected by the Sharia Guarantee Company or Sharia Business Unit per current year. f) Claim Approved But Not Yet Paid (Rp) This field is filled with the claim value approved but not yet paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
Guarantee for Procurement of Goods and/or Services (Surety Bond)
a) Claim Submission (Rp)
This field is filled with the claim value submitted to the Sharia Guarantee Company or Sharia Business Unit per current year. b) Claim Processed (Rp) This field is filled with the claim value currently being processed by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Approved (Rp) This field is filled with the claim value approved by the Sharia Guarantee Company or Sharia Business Unit per current year. d) Claim Paid (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year. e) Claim Rejected (Rp) This field is filled with the claim value rejected by the Sharia Guarantee Company or Sharia Business Unit per current year. f) Claim Approved But Not Yet Paid (Rp) This field is filled with the claim value approved but not yet paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
Bank Guarantee Guarantee (Counter Bank Guarantee)
a) Claim Submission (Rp)
This field is filled with the claim value submitted to the Sharia Guarantee Company or Sharia Business Unit per current year. b) Claim Processed (Rp) This field is filled with the claim value currently being processed by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Approved (Rp) This field is filled with the claim value approved by the Sharia Guarantee Company or Sharia Business Unit per current year. d) Claim Paid (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year. e) Claim Rejected (Rp) This field is filled with the claim value rejected by the Sharia Guarantee Company or Sharia Business Unit per current year. f) Claim Approved But Not Yet Paid (Rp) This field is filled with the claim value approved but not yet paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
Domestic Documentary Credit Guarantee
a) Claim Submission (Rp)
This field is filled with the claim value submitted to the Sharia Guarantee Company or Sharia Business Unit per current year. b) Claim Processed (Rp) This field is filled with the claim value currently being processed by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Approved (Rp) This field is filled with the claim value approved by the Sharia Guarantee Company or Sharia Business Unit per current year. d) Claim Paid (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year. e) Claim Rejected (Rp) This field is filled with the claim value rejected by the Sharia Guarantee Company or Sharia Business Unit per current year. f) Claim Approved But Not Yet Paid (Rp) This field is filled with the claim value approved but not yet paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
Letter of Credit Guarantee
a) Claim Submission (Rp)
This field is filled with the claim value submitted to the Sharia Guarantee Company or Sharia Business Unit per current year. b) Claim Processed (Rp) This field is filled with the claim value currently being processed by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Approved (Rp) This field is filled with the claim value approved by the Sharia Guarantee Company or Sharia Business Unit per current year. d) Claim Paid (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year. e) Claim Rejected (Rp) This field is filled with the claim value rejected by the Sharia Guarantee Company or Sharia Business Unit per current year. f) Claim Approved But Not Yet Paid (Rp) This field is filled with the claim value approved but not yet paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
Customs Bond Guarantee
a) Claim Submission (Rp)
This field is filled with the claim value submitted to the Sharia Guarantee Company or Sharia Business Unit per current year. b) Claim Processed (Rp) This field is filled with the claim value currently being processed by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Approved (Rp) This field is filled with the claim value approved by the Sharia Guarantee Company or Sharia Business Unit per current year. d) Claim Paid (Rp) This field is filled with the claim value paid by the Sharia Guarantee Company or Sharia Business Unit per current year. e) Claim Rejected (Rp) This field is filled with the claim value rejected by the Sharia Guarantee Company or Sharia Business Unit per current year. f) Claim Approved But Not Yet Paid (Rp) This field is filled with the claim value approved but not yet paid by the Sharia Guarantee Company or Sharia Business Unit per current year.
Excise Guarantee
a) Claim Submission (Rp)
This field is filled with the claim value submitted to the Sharia Guarantee Company or Sharia Business Unit per current year. b) Claim Processed (Rp) This field is filled with the claim value currently being processed by the Sharia Guarantee Company or Sharia Business Unit per current year. c) Claim Approved (Rp) This field is filled with the claim value approved by the Sharia Guarantee Company or Sharia Business Unit per current year.

d) Claims Paid (Rp)
This item is filled with the value of claims paid by the Sharia Guarantee Company or UUS per current year. e) Claims Rejected (Rp) This item is filled with the value of claims rejected by the Sharia Guarantee Company or UUS per current year. f) Claims Approved but Not Yet Paid (Rp) This item is filled with the value of claims approved but not yet paid by the Sharia Guarantee Company or UUS per current year.

Provision of Management Consulting Services related to Guarantor Business Activities
a) Claim Submission (Rp)
This item is filled with the value of claims submitted to the Sharia Guarantee Company or UUS per current year. b) Claims Processed (Rp) This item is filled with the value of claims currently being processed by the Sharia Guarantee Company or UUS per current year. c) Claims Approved (Rp) This item is filled with the value of claims approved by the Sharia Guarantee Company or UUS per current year. d) Claims Paid (Rp) This item is filled with the value of claims paid by the Sharia Guarantee Company or UUS per current year. e) Claims Rejected (Rp) This item is filled with the value of claims rejected by the Sharia Guarantee Company or UUS per current year. f) Claims Approved but Not Yet Paid (Rp) This item is filled with the value of claims approved but not yet paid by the Sharia Guarantee Company or UUS per current year.
Other Business Activities after Receiving Approval from the Financial Services Authority
a) Claim Submission (Rp)
This item is filled with the value of claims submitted to the Sharia Guarantee Company or UUS per current year. b) Claims Processed (Rp) This item is filled with the value of claims currently being processed by the Sharia Guarantee Company or UUS per current year. c) Claims Approved (Rp) This item is filled with the value of claims approved by the Sharia Guarantee Company or UUS per current year. d) Claims Paid (Rp) This item is filled with the value of claims paid by the Sharia Guarantee Company or UUS per current year. e) Claims Rejected (Rp) This item is filled with the value of claims rejected by the Sharia Guarantee Company or UUS per current year. f) Claims Approved but Not Yet Paid (Rp) This item is filled with the value of claims approved but not yet paid by the Sharia Guarantee Company or UUS per current year.
Total
a) Claim Submission (Rp)
This item is filled with the value of claims submitted to the Sharia Guarantee Company or UUS per current year. b) Claims Processed (Rp) This item is filled with the value of claims currently being processed by the Sharia Guarantee Company or UUS per current year. c) Claims Approved (Rp) This item is filled with the value of claims approved by the Sharia Guarantee Company or UUS per current year. d) Claims Paid (Rp) This item is filled with the value of claims paid by the Sharia Guarantee Company or UUS per current year. e) Claims Rejected (Rp) This item is filled with the value of claims rejected by the Sharia Guarantee Company or UUS per current year. f) Claims Approved but Not Yet Paid (Rp) This item is filled with the value of claims approved but not yet paid by the Sharia Guarantee Company or UUS per current year.

S. FORM 4100: ASSET AND LIABILITY MATURITY ANALYSIS REPORT

FORM 4100 (ASSET AND LIABILITY MATURITY ANALYSIS REPORT) FORMAT
FORM 4100 ASSET AND LIABILITY MATURITY ANALYSIS REPORT is prepared in the following format:

Asset/Liability Age
< 1 year
1 year < age < 5 years
5 years < age < 10 years
10 years
Total

FORM 4100 (ASSET AND LIABILITY MATURITY ANALYSIS REPORT) EXPLANATION
FORM 4100 ASSET AND LIABILITY MATURITY ANALYSIS REPORT contains information regarding the recapitulation of assets and liabilities detailed by related asset and liability ratios, with the following explanation:

Age
This item represents the age of assets, liabilities, or the ratio of assets to liabilities, namely < 1 year, 1 year < age < 5 years, 5 years < age < 10 years, and > 10 years.
Assets
This item is filled with the asset value of the Sharia Guarantee Company or UUS in the reporting period.
Liabilities
This item is filled with the liability value of the Sharia Guarantee Company or UUS in the reporting period.

T. FORM 5100: OPERATIONAL PERFORMANCE OF SHARIA GUARANTEE COMPANIES OR UUS

FORM 5100 (OPERATIONAL PERFORMANCE OF SHARIA GUARANTEE COMPANIES OR UUS) FORMAT
FORM 5100 OPERATIONAL PERFORMANCE OF SHARIA GUARANTEE COMPANIES OR UUS is prepared in the following format:
a. Sharia Guarantee Company

No.
Financial Health Measurement
Criteria Analysis
Composite Weight Value

Liquidity Ratio 10%
Gearing Ratio 35%
Rentability
a. Return on Asset (ROA) 30%
35% b. Operating Expenses / Operating Income (BOPO) 35%
c. Claims against IJK Income 35%
Self-assessment Good Corporate Governance (GCG) 20%

Total Composite Financial Health
Company Financial Health Category

b. UUS

No.
Financial Health Measurement
Criteria Analysis
Composite Weight Value

Liquidity Ratio 30%
Rentability
a. ROA 30%
50% b. BOPO 35%
c. Claims against IJK Income 35%
Self-assessment GCG 20%

Total Composite Financial Health
Company Financial Health Category

FORM 5100 (OPERATIONAL PERFORMANCE OF SHARIA GUARANTEE COMPANIES AND UUS) EXPLANATION
FORM 5100 OPERATIONAL PERFORMANCE OF SHARIA GUARANTEE COMPANIES AND UUS contains operational performance, with the following explanation:
a. Sharia Guarantee Company

No.
This item is filled with the sequence number in the form row.
Financial Health Measurement
This item is filled with financial health measurements in accordance with Financial Services Authority Circular Letter Number 18/SEOJK.05/2018 concerning Financial Health of Guarantee Institutions (SEOJK 18/2018), namely Liquidity Ratio, Gearing Ratio, Rentability (ROA, BOPO, and claims against IJK income), and self-assessment of good corporate governance.
Analysis
This item is filled with the results of financial health measurements calculated in accordance with SEOJK 18/2018.
Criteria Value
This item is filled with the criteria from the results of financial health measurements determined in accordance with SEOJK 18/2018.
Weight
This item is filled with the weight of each financial health measurement in accordance with SEOJK 18/2018, namely 10% for liquidity ratio, 35% for gearing ratio, 35% for rentability (30% for ROA, 35% for BOPO, and 35% for claims against IJK income), and 20% for self-assessment GCG.
Composite
This item is filled with the result of the multiplication between column number (4) and column number (5).
Total Composite Financial Health
This item is filled with the total composite financial health calculated using the calculation method in accordance with SEOJK 18/2018.
Company Financial Health Category
This item is filled with the company financial health category in the form of Financial Health Level (TKK) and company financial health categories determined in accordance with SEOJK 18/2018.

b. UUS

No.
This item is filled with the sequence number in the form row.
Financial Health Measurement
This item is filled with financial health measurements in accordance with Financial Services Authority Circular Letter Number 18/SEOJK.05/2018 concerning Financial Health of Guarantee Institutions (SEOJK 18/2018), namely Liquidity Ratio, Gearing Ratio, Rentability (ROA, BOPO, and claims against IJK income), and self-assessment of good corporate governance.
Analysis
This item is filled with the results of financial health measurements calculated in accordance with SEOJK 18/2018.
Criteria Value
This item is filled with the criteria from the results of financial health measurements determined in accordance with SEOJK 18/2018.
Weight
This item is filled with the weight of each financial health measurement in accordance with SEOJK 18/2018, namely 30% for liquidity ratio, 50% for rentability (30% for ROA, 35% for BOPO, and 35% for claims against IJK income), and 20% for self-assessment GCG.
Composite
This item is filled with the result of the multiplication between column number (4) and column number (5).
Total Composite Financial Health
This item is filled with the total composite financial health calculated using the calculation method in accordance with SEOJK 18/2018.
Company Financial Health Category
This item is filled with the company financial health category in the form of Financial Health Level (TKK) and company financial health categories determined in accordance with SEOJK 18/2018.

U. FORM 6100: SUBROGATION RECEIVABLES REPORT

FORM 6100 (SUBROGATION RECEIVABLES REPORT) FORMAT
FORM 6100 SUBROGATION RECEIVABLES REPORT is prepared in the following format:

No.
Description
Value

Opening Balance
Added/(Subtracted):
a. Claim Payment b. Subrogation Installment
Closing Balance
FORM 6100 (SUBROGATION RECEIVABLES REPORT) EXPLANATION
FORM 6100 SUBROGATION RECEIVABLES REPORT contains a report regarding the development of subrogation receivables, with the following explanation:

No.
This item is filled with the sequence number in the form row.
Description
a. Opening Balance
This item is the opening balance of subrogation receivables at the beginning of the year. b. Added/(Subtracted) a) Claim Payment This item is the total claim payments from the beginning of the year to the reporting date. b) Subrogation Installment This item is the total subrogation installments received by the Sharia Guarantee Company or UUS from the beginning of the year to the reporting date.
c. Closing Balance
This item is the closing balance of subrogation receivables on the reporting date.
Value
This item is filled with the value of the Opening Balance, Claim Payment, Subrogation Installment, and Closing Balance items.

V. FORM 7100: GEARING RATIO REPORT

FORM 7100 (GEARING RATIO REPORT) FORMAT
FORM 7100 GEARING RATIO REPORT is prepared in the following format:
No. Description
Productive Business
Non-Productive Business
Total
Value of Guarantees Assumed Directly
Net Own Capital
Gearing Ratio (Row 1:2)
FORM 7100 (GEARING RATIO REPORT) EXPLANATION
FORM 7100 GEARING RATIO REPORT contains a gearing ratio report detailed by productive and non-productive business, with the following explanation:

Value of Guarantees Assumed Directly
This item is filled with the value of outstanding guarantees assumed by the Sharia Guarantee Company or UUS.
Net Own Capital
This item is filled with the net own capital value of the Sharia Guarantee Company or UUS in accordance with applicable regulations.
Gearing Ratio
This item is filled with the ratio between the value of guarantees assumed directly and net own capital.

W. FORM 8100: FINANCING GUARANTEE QUALITY REPORT

FORM 8100 (FINANCING GUARANTEE QUALITY REPORT) FORMAT
FORM 8100 FINANCING GUARANTEE QUALITY REPORT is prepared in the following format:
No. Collectibility
Productive Business
Non-Productive Business
Total
Current
Special Attention
Less Current
Doubtful
Loss
Total (Row 1+2+3+4+5)
Non Performing Guarantee/NPG (Row 3+4+5)
NPG Ratio (Row 7:6)
FORM 8100 (FINANCING GUARANTEE QUALITY REPORT) EXPLANATION
FORM 8100 FINANCING GUARANTEE QUALITY REPORT contains a report on the collectibility of guaranteed financing, namely current, special attention, less current, doubtful, and loss, detailed by productive and non-productive business, with the following explanation:

Collectibility: Current
This item is filled with the amount of guaranteed financing that has Current collectibility.
Collectibility: Special Attention
This item is filled with the amount of guaranteed financing that has Special Attention collectibility.
Collectibility: Less Current
This item is filled with the amount of guaranteed financing that has Less Current collectibility.
Collectibility: Doubtful
This item is filled with the amount of guaranteed financing that has Doubtful collectibility.
Collectibility: Loss
This item is filled with the amount of guaranteed financing that has Loss collectibility.
Total
This item is filled with the total amount of guaranteed financing.
Non Performing Guarantee/NPG
This item is filled with the amount of guaranteed financing that has Less Current, Doubtful, and Loss collectibility.
NPG Ratio
This item is filled with the ratio between the amount of guaranteed financing that has Less Current, Doubtful, and Loss collectibility and the total amount of guaranteed financing.

X. FORM 9100: TOP 10 NON PERFORMING GUARANTEE/NPG REPORT

FORM 9100 (NON PERFORMING GUARANTEE/NPG) FORMAT
FORM 9100 NON PERFORMING GUARANTEE/NPG is prepared in the following format:

No.
Name
Collectibility
Guarantee Recipient
Guarantee Value

FORM 9100 (NON PERFORMING GUARANTEE/NPG) EXPLANATION
FORM 9100 NON PERFORMING GUARANTEE/NPG contains a report regarding the 10 (ten) guarantors with the largest Non Performing Guarantee/NPG value, with the following explanation:

No.
This item is filled with the sequence number in the form row.
Name of Guarantor
This item is filled with the name of the guarantor.
Collectibility
This item is filled with the collectibility of the guarantor.
Guarantee Recipient
This item is filled with the name of the guarantee recipient that disbursed financing to the guarantor.
Guarantee Value
This item is filled with the value of the guarantee provided by the Sharia Guarantee Company or UUS.

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

Established in Jakarta on 6 January 2023
EXECUTIVE HEAD OF SUPERVISOR OF
INSURANCE, PENSION FUNDS,
LENDING INSTITUTIONS, AND
OTHER FINANCIAL SERVICES INSTITUTIONS
FINANCIAL SERVICES AUTHORITY
REPUBLIC OF INDONESIA,

signed
OGI PRASTOMIYONO

APPENDIX IV
CIRCULAR LETTER OF THE FINANCIAL SERVICES AUTHORITY REPUBLIC OF INDONESIA NUMBER 1/SEOJK.05/2023 CONCERNING MONTHLY REPORT OF GUARANTEE COMPANIES, SHARIA GUARANTEE COMPANIES, AND SHARIA BUSINESS UNITS

FORMAT 1: REPORT OF CHANGE OF DIRECTORS RESPONSIBLE FOR MONTHLY REPORTS AND/OR MONTHLY REPORT PREPARATION OFFICERS COMPANY LETTERHEAD Number :
Date :
Attachment :
Subject : Report of Change of Directors Responsible for Monthly Reports and/or Monthly Report Preparation Officers

To:
Financial Services Authority u.p. Directorate of Statistics and IKNB Information Wisma Mulia 2 Building, 18th Floor Jalan Jenderal Gatot Subroto Kav. 40 Jakarta 12710

Change of Directors responsible for monthly reports;
and/or
Change of monthly report preparation officers,
with the following changes:

Position Description Before After
Director
Responsible
Name
Position in Company
Email
Phone
Preparation Officer
Name
Position in Company
Email
Phone

We submit this report, and thank you for your attention, Sir/Madam*) Sincerely, Board of Directors PT Signature, name, and wet seal ( ) *) delete as necessary

FORMAT 2: APPLICATION FOR USER ID AND PASSWORD FOR MONTHLY REPORT APPLICATION COMPANY LETTERHEAD Number :
Date :
Attachment :
Subject : Application for User ID and Password for Monthly Report Application

To:
Financial Services Authority u.p. Directorate of Statistics and IKNB Information Wisma Mulia 2 Building, 18th Floor Jalan Jenderal Gatot Subroto Kav. 40 Jakarta 12710

Referring to Financial Services Authority Circular Letter Number … dated … concerning Monthly Report of Guarantee Companies, Sharia Guarantee Companies, and Sharia Business Units, we hereby apply on behalf of:
Company : ____________________
Company Code : ____________________
For the acquisition of user ID and password for Monthly Report submission with the name of the Monthly Report preparation officer as follows:
Name : _____________________________________________________________ Position : _____________________________________________________________ Email : _____________________________________________________________ Phone : _____________________________________________________________

We submit this application, and thank you for your attention, Sir/Madam*) Sincerely, Board of Directors PT Signature, name, and wet seal ( ) *) delete as necessary

FORMAT 3: APPLICATION FOR CHANGE OF USER ID AND PASSWORD FOR MONTHLY REPORT APPLICATION COMPANY LETTERHEAD Number :
Date :
Attachment :
Subject : Application for Change of User ID and Password for Monthly Report Application

To:
Financial Services Authority u.p. Directorate of Statistics and IKNB Information Wisma Mulia 2 Building, 18th Floor Jalan Jenderal Gatot Subroto Kav. 40 Jakarta 12710

Referring to Financial Services Authority Circular Letter Number … dated … concerning Monthly Report of Guarantee Companies, Sharia Guarantee Companies, and Sharia Business Units, we hereby apply on behalf of:
Company : ____________________
Company Code : ____________________
For the acquisition of user ID and password for Monthly Report submission with the name of the Monthly Report preparation officer as follows:
Name : _______________________________
Position : _______________________________
Email : _______________________________
Phone : _______________________________
Old User ID (User ID) : _______________________________ Old Password (Password) : _______________________________

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

We submit this application, and thank you for your attention, Sir/Madam*) Sincerely, Board of Directors PT Signature, name, and wet seal ( ) *) delete as necessary

signed
OGI PRASTOMIYONO

Monthly Report of Guarantee Companies, Sharia Guarantee Companies, and Sharia Business Units

Lineage: In force