Perusahaan Perseroan Persero PT Telekomunikasi Indonesia Tbk : Statement Letter of Independent Shareholders

STATEMENT LETTER OF INDEPENDENT/AFFILIATED SHAREHOLDER*

PERUSAHAAN PERSEROAN (PERSERO) PT TELEKOMUNIKASI INDONESIA TBK

I, the undersigned:
Name	:
Position*)	:
*) Must be filled in if acting as Authorized Person from a Legal Entity
Address	:
ID Card/Passport Number :
E-mail Address	:
Telephone Number	:
Please circle the correct statement
acting [for himself/herself] [as the Authorized Person of]:
To be filled in if acting as Authorized Person of an Individual or a Legal Entity
Name	:

ID Card/Passport Number*):

*) Must be filled in if the principal is an Individual Entity

Address/Domicile	:
E-mail Address	:
Telephone Number	:

as Independent/Affiliated Shareholder* ("Shareholder") of ………………………… shares in

PERUSAHAAN PERSEROAN (PERSERO) PT TELEKOMUNIKASI INDONESIA TBK (the "Company"), having its domicile in Bandung, in connection with the forthcoming Annual General Meeting of Shareholders ("AGMS") on May 30th, 2023, with one of the AGMS Agenda of which requires the approval from Independent Shareholders, namely the Fifth Agenda concerning:

"Approval of the Company's Proposed Business Spin Off which is an Affiliated Transaction as referred to in Financial Services Authority Regulation No. 42/2020 on Affiliated and Conflict of Interest Transaction, and a Material Transaction as referred to in Financial Services Authority Regulation No. 17/2020 on Material Transactions and Changes in Business Activities."

Hereby declare truthfully as follows:

Please kindly mark [ ✓ ] on the correct statement:

• It is true that the Shareholder is an Independent Shareholder that: (i) has no personal economic interest in connection with the Proposed Transaction; and (ii) is not a member of the Board of Directors, a member of the Board of Commissioners, majority shareholder, and controller of the Company or is not an affiliate of members of the Board of Directors, members of the Board of Commissioners, majority shareholder and controller of the Company as stipulated in POJK 42 and POJK 17

2 It is true that the Shareholder is an Affiliated Shareholder as stipulated in POJK 42 and POJK 17.

3. If in the future it is proven that this statement is incorrect, the Shareholder understand that the Shareholder may be subject to penalties in accordance with the provisions of the applicable laws and regulations.

Thus, this statement is made truthfully for the purposes of the quorum and decision-making on the agenda as referred to.

[Signing location], Declarator,

Stamp Duty IDR10,000*)

Name: …………………………………

*) if signed outside of Indonesia, this statement letter must be post-dated stamped (Nazegelen)