LGHBIRDB Reports ‐ Indonesia

Production date
23‐Sep‐2021
Requested date
28‐May‐2021

PT. Sample Company

ABOUT COMPANY

CRIF Number ID0000000579 ADDRESS & CONTACTS

NPWP 72.539.XXX.X‐022.000 Address Sample Building, 26, Sample Street, Kav. 86, Karet
Latest Legalization AHU‐003XXXX.AH.01.02.Tahun 2019 Tengsin, Tanah Abang, Kota Jakarta Pusat, 10220,
from 13‐Jun‐2019 DKI Jakarta, Indonesia

Legal Form Perseroan Publik (PT. TBK): Telephone(s) +62 21 80640000

Public Listed Company (TBK) Fax(es) +62 21 80640000*
Company Status Active Email(s) sample.email​@domain.co.id
Company Type Headquarter Website(s) www.samplesite.id
Start Activity Date 01‐Jun‐2015 * Main contact of the company.
Employees 8499
Activity Code(s) 23390310
Apparel and Other Textile Products ‐
WOMEN'S AND MISSES' OUTERWEAR,
NEC ‐ SPORTSWEAR, WOMEN'S

LOCATIONS

Current Location

Type of Occupation Leased Premises used as Operations office

Location Central business district Premises is are proximity to A major road network

OTHER COMPANY ADDRESSES

Current Addresses
Store

Address 1 Sample Building, Sample Street, Seminyak, Kuta, Kab. Badung, 80361, Bali, Indonesia

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PT. Sample Company

Requested on: 28‐May‐2021
Produced on: 23‐Sep‐2021

ACTIVITIES

Company Status Active

Date Activity Start 01‐Jun‐2015

Activity
Code Description
Level

23390310 Apparel and Other Textile Products ‐ WOMEN'S AND MISSES' OUTERWEAR, NEC ‐ SPORTSWEAR, WOMEN'S 1st

Apparel and Other Textile Products ‐ MEN'S AND BOY'S CLOTHING, NEC ‐ MEN'S AND BOYS' SPORTSWEAR AND
23290100 2nd
ATHLETIC CLOTHING

56619902 Apparel and Accessory Stores ‐ SHOE STORES ‐ FOOTWEAR, ATHLETIC 3rd

67190000 Holding and Other Investment Offices ‐ HOLDING COMPANIES, NEC 4th

59619916 Miscellaneous Retail ‐ CATALOG AND MAIL‐ORDER HOUSES ‐ MAIL ORDER HOUSE, NEC 5th

59450200 Miscellaneous Retail ‐ HOBBY, TOY, AND GAME SHOPS ‐ TOYS AND GAMES 5th

LEGAL STRUCTURE AND REGISTRATIONS

Legal Form Perseroan Publik (PT. TBK): Valid from 13‐Apr‐2018

Public Listed Company (TBK)
Major Investors Distribution Foreign invested company

Registrations

LEGALIZATION AHU‐003XXXX.AH.01.02.Tahun 2019 The Ministry of Law and Human Rights 13‐Jun‐2019
LEGALIZATION AHU‐AH.01.03‐022XXXX The Ministry of Law and Human Rights 07‐Aug‐2018
LEGALIZATION AHU‐000XXXX.AH.01.02.Tahun 2018 The Ministry of Law and Human Rights 13‐Apr‐2018

LEGALIZATION AHU‐AH.01.03‐094XXXX The Ministry of Law and Human Rights 08‐Jul‐2015

LEGALIZATION AHU‐AH.01.03‐094XXXX The Ministry of Law and Human Rights 08‐Jul‐2015
LEGALIZATION AHU‐093XXXX.AH.01.02.Tahun 2015 The Ministry of Law and Human Rights 01‐Jun‐2015
LEGALIZATION AHU‐001XXXX.AH.01.01.Tahun 2015 The Ministry of Law and Human Rights 13‐Mar‐2015
NPWP 72.539.XXX.X‐022.000 Direktorat Jenderal Pajak ‐

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PT. Sample Company

Requested on: 28‐May‐2021
Produced on: 23‐Sep‐2021

OTHER REGISTRATIONS AND CERTIFICATIONS

Type and Number Releasing authority Awarded On Expired On

TDP 812000981XXXX Kementerian Perdagangan Republik Indonesia ‐ ‐

CAPITALS

Capital
Capital Type Capital Amount Start Validity Date

Authorized Capital 500,000,000,000.00 IDR 31‐Mar‐2020

Issued Capital 285,040,000,000.00 IDR 31‐Mar‐2020

Paid‐up Capital 285,040,000,000.00 IDR 31‐Mar‐2020

SHAREHOLDERS

Shareholders List

Total no. of Shareholders 3 Total no. of Shares 2,835,784,700

Total Amount of Shares 285,052,161,533.99 IDR Shareholders list start validity date 31‐Mar‐2020

Shareholders
Name Country Share Type Amount per Share Number Amount %*

Shareholder 1 Indonesia Ordinary Shares 100.00 IDR 1,962,299,080 197,703,599,533.99 IDR 69.36

Shareholder 2 ‐ Ordinary Shares 100.00 IDR 659,588,300 65,958,830,000.00 IDR 23.14

Shareholder 3 Cayman Islands Ordinary Shares 100.00 IDR 213,897,320 21,389,732,000.00 IDR 7.50

*Due to rounding, the total percentage of shares may slightly differ from 100.

Shareholders Details

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PT. Sample Company

Requested on: 28‐May‐2021
Produced on: 23‐Sep‐2021

Shareholder 1
Country Indonesia Shareholder Type Corporate Entities

Shareholder 2
Shareholder Type Public

Shareholder 3
Country Cayman Islands Shareholder Type Corporate Entities

MANAGEMENT

MR INDIVIDUAL 1

Nationality United Kingdom

Corporate Board Director: Yes
Current Title: Acting President Director
Valid from 31‐Mar‐2020

MR INDIVIDUAL 2

Nationality United Kingdom

Current Title: Acting Commissioner
Valid from 31‐Mar‐2020

MS INDIVIDUAL 3

Nationality Indonesia
Current Title: Acting Commissioner
Valid from 31‐Mar‐2020

MR INDIVIDUAL 4

Nationality United Kingdom

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Requested on: 28‐May‐2021
Produced on: 23‐Sep‐2021

Current Title: Acting Commissioner

Valid from 31‐Mar‐2020

MR INDIVIDUAL 6

Nationality Indonesia
Corporate Board Director: Yes
Current Title: Acting Director
Valid from 31‐Mar‐2020

MR INDIVIDUAL 7

Nationality India

Corporate Board Director: Yes

Current Title: Acting Director
Valid from 31‐Mar‐2020

MR INDIVIDUAL 8

Nationality United Kingdom

Corporate Board Director: Yes
Current Title: Acting Director
Valid from 31‐Mar‐2020

MR INDIVIDUAL 5

Nationality Indonesia
Corporate Board Director: Yes
Current Title: Acting Director

MR INDIVIDUAL 9

Nationality India
Current Title: Acting President Commissioner
Valid from 31‐Mar‐2020

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PT. Sample Company

Requested on: 28‐May‐2021
Produced on: 23‐Sep‐2021

MANAGEMENT ASSESSMENT AND AUTHORIZED SIGNATURES

The management is deemed to have sufficient experience and industry expertise to manage the subject properly.

Individual 1 serves as a President Commissioner of PT. Sample Company 1 since 2004. His previous position includes as Advisor for PT. Sample
Company 2 from 1989 to 1995. He received a Bachelor's degree in Commerce in 1977 and Bachelor’s degree in Law in 1980 from University of
Rajasthan, India. In 1996, he received a Master of Business Administration from the University of Hull, United Kingdom. He was a finalist of Ernst &
Young’s Entrepreneur of the Year Award in 2007.

LITIGATIONS

Search Date 06‐Aug‐2020 Charges Source Local district Court ‐ SIPP, Kota
Jakarta Pusat, DKI Jakarta
Search Result Negative

LITIGATIONS

At the time this report was written, the Company has not been involved in any criminal or civil cases. This statement is based on the
search results for cases conducted at the State Court in the area where the Company was established and operates today.

RELATED COMPANIES

Parent

Company Name Related Company 1 Country Cayman Islands

Other Information
Line of business (Activities of holding companies)

Company Name Related Company 2 Country Indonesia

Other Information
Line of business (Activities of holding companies)

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PT. Sample Company

Requested on: 28‐May‐2021
Produced on: 23‐Sep‐2021

Company Name Related Company 3

Other Information
Line of business (Unlimited Company)

Subsidiares

Company Name Related Company 6 Country Singapore

Other Information
Line of business (Activities of holding companies)

Company Name Related Company 7 Country Indonesia

Other Information
Line of business (Retail sale of footwear and leather goods in specialised stores)

Company Name Related Company 8 Country Indonesia

Other Information
Line of business (Retail sale of clothing in specialised stores)

Company Name Related Company 9 Country Vietnam

Other Information
Line of business (Retail sale of footwear and leather goods in specialised stores)

Company Name Related Company 10 Country Indonesia

Other Information
Line of business (Other retail sale of new goods in specialised stores)

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PT. Sample Company

Requested on: 28‐May‐2021
Produced on: 23‐Sep‐2021

Affiliates

Company Name Related Company 4 Country Indonesia

Other Information
Line of business (Retail sale of clothing in specialised stores)

Company Name Related Company 5

Other Information
Line of business (Unlimited Company)

EMPLOYEES

Last Collection Data

Date of Figure 31‐Mar‐2020

Total Employees of the company 8,499

Previous Collection Data

Date of Figure 31‐Dec‐2019

Total Employees of the company 8,760

Date of Figure 31‐Dec‐2018

Total Employees of the company 7,681

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PT. Sample Company

Requested on: 28‐May‐2021
Produced on: 23‐Sep‐2021

CUSTOMERS

Customers Quantity 3

PT. Customer 1
Country Indonesia Customer Type Retailer(s)

PT. Customer 2
Country Indonesia Customer Type Retailer(s)

PT. Customer 3
Country Indonesia Customer Type Retailer(s)

SUPPLIERS

Suppliers Quantity 2

PT. Supplier 1
Country Indonesia Currency IDR (Indonesia Rupiah)

PT. Supplier 2
Country Indonesia Currency IDR (Indonesia Rupiah)

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PT. Sample Company

Requested on: 28‐May‐2021
Produced on: 23‐Sep‐2021

SALES & PURCHASES

Purchases

The company carries out: Local Purchases

Local purchases ‐ 100.00 %

Sales and Purchases Terms

Credit Type Term Credit Terms Application Net Days from Net Days to

Local Purchase Open Account 30 ‐

Local Purchase Open Account 60 ‐

Local Sales Cash ‐ ‐

BANKS

Bank Name PT. Bank 4

Bank Name PT. Bank 2

Bank Name PT. Bank 3

Bank Name PT. Bank 1

INSURANCE

Company Name Insurance Company 1

Company Name Insurance Company 2

Company Name Insurance Company 3

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PT. Sample Company

Requested on: 28‐May‐2021
Produced on: 23‐Sep‐2021

HISTORICAL - LEGAL EVENTS

Changes in Capital
Capital Type Capital Amount Start Validity Date

Authorized Capital 500,000,000,000.00 IDR 31‐Mar‐2020

Authorized Capital (former) 500,000,000,000.00 IDR 30‐Jun‐2018

Issued Capital 285,040,000,000.00 IDR 31‐Mar‐2020

Issued Capital (former) 238,000,000,000.00 IDR 30‐Jun‐2018

Issued Capital (former) 238,000,000,000.00 IDR 30‐Jun‐2018

Paid‐up Capital 285,040,000,000.00 IDR 31‐Mar‐2020

Changes in Company Name

Present Name PT. Sample Company (From 13‐Apr‐2018)

Previous Name * PT. Former Sample Company (From 11‐Mar‐2015)

* Original company name

Changes in Legal Structure

Current Legal Form Perseroan Publik (PT. TBK): Public Listed Company (TBK) (From 13‐Apr‐2018)

Previous Legal Form Perseroan Terbatas (PT): Private Limited Liability Company (PT) (From 11‐Mar‐2015)

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Requested on: 28‐May‐2021
Produced on: 23‐Sep‐2021

APPENDIX

Customer service

If you require further information or have any concerns, please contact our Customer Service.

PT VISI GLOBALINDO DATA UTAMA

Jl. Layur Selatan No 17B, Jati, Pulogadung, Jakarta Timur,
13220 Jakarta, Indonesia
Telephone Number: +62 (21) 298‐333‐49
Email Address: visi.customercare‐jk@crif.com

Inquiries should always contain the below minimum details:

Full Company Name

Full Headquarters Address
Telephone Number
Business Identification Number
Contact Name
Reference
Order Date

Disclaimer & confidentiality

THIS INFORMATION IS PROVIDED BY PT VISI GLOBALINDO DATA UTAMA (PT VISI) AT YOUR REQUEST SUBJECT TO THE TERMS AND
CONDITIONS OF YOUR SUBSCRIPTION CONTRACT AND IS NOT TO BE DISCLOSED.

This report is furnished to the Subscriber in strict confidence for the sole and exclusive use by the Subscriber as one factor to consider in
connection with credit and other business decisions. This report contains information compiled from various sources which PT VISI does
not control and which has not been verified unless otherwise indicated in this report. PT VISI, therefore, does not accept responsibility
for the accuracy, completeness, or timeliness of the report. PT VISI disclaims any and all liability for any loss or damage arising out of or
in any way related to the use of the contents of this report. This report is strictly confidential and proprietary to PT VISI and/or
information provider of PT VISI and may not be reproduced, published, or disclosed to others without the express written authorization
of PT VISI

COPYRIGHT 2020 PT VISI GLOBALINDO DATA UTAMA THIS REPORT MAY NOT BE REPRODUCED IN WHOLE OR IN PART IN ANY FORM OR
MANNER WHATSOEVER.

END OF REPORT

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