Dematerialization Form Template for Indonesia

The Dematerialization Form serves as a crucial instrument in Indonesia's modernization of its securities market infrastructure. This document is required when security holders wish to convert their physical securities certificates into electronic form for trading and settlement through the KSEI (Indonesian Central Securities Depository) system. The form must be submitted through an authorized depository participant and includes comprehensive details about the security holder, the securities to be dematerialized, and various declarations ensuring the authenticity of the submission. It aligns with Indonesia's capital market regulations, particularly Law No. 8 of 1995 and related POJK regulations, and forms part of the country's broader initiative to enhance market efficiency and reduce risks associated with physical securities handling.

1. Security Holder Information: Details of the registered owner(s) including full name, ID number, address, and contact information

2. Securities Details: Information about the physical securities to be dematerialized including security type, certificate numbers, quantity, and face value

3. Depository Participant Details: Information about the securities account and the depository participant through whom the dematerialization is being processed

4. Dematerialization Request: Formal request statement for converting physical securities to electronic form

5. Declaration: Security holder's declaration of ownership and authenticity of the certificates

6. Verification of Documents: Checklist of required supporting documents submitted with the form

7. Authorization: Authority given to the depository participant to process the dematerialization