| No. | Nama | Paraf |
|---|---|---|
| 1 | SAPARI | |
| 2 | LUKMAN HAKIM | |
| 3 | SUGIANTO | |
| 4 | RUDI RISTANTO | |
| 5 | MUHAMAD WALID LILKHALIM | |
| 6 | SUTRISNO | |
| 7 | SUPRIHATIN | |
| 8 | SUPARNO | |
| 9 | SISWADI | |
| 10 | MAHRIL | |
| 11 | WAHRI | |
| 12 | SLAMET TAMAMI | |
| 13 | KURDI | |
| 14 | AHMAD TAMIYIS | |
| 15 | JAELANI | |
| 16 | WALDI | |
| 17 | MUH DARWI | |
| 18 | MUHAMAD WAKHID | |
| 19 | SUNARYO | |
| 20 | SARIJAN | |
| 21 | MUZAYIN | |
| 22 | ARIYANTO | |
| 23 | SURURI | |
| 24 | WAHADIYONO | |
| 25 | MUHAMMAD | |
| 26 | AHMAD NASIKHIN | |
| 27 | KHOSIATUN | |
| 28 | NUR KHASANAH | |
| 29 | MUHAMAD ABDUL KAFI | |
| 30 | MARSIYAH |