| No. | Nama | Paraf |
|---|---|---|
| 1 | KAMSIJAH | |
| 2 | SUSWADI | |
| 3 | ILYASIN | |
| 4 | SURATI | |
| 5 | ABDUL SA'ID | |
| 6 | SUTORO | |
| 7 | ARHAMU FAIM | |
| 8 | LANTAR WIYONO | |
| 9 | AZIZ MUSLIHIN | |
| 10 | SUPARNO | |
| 11 | NURHAYATI | |
| 12 | KHUSNIYAH | |
| 13 | MUH IRFAN | |
| 14 | ASHUDI | |
| 15 | SUGIYONO | |
| 16 | DARYONO | |
| 17 | NUR KHOLIS | |
| 18 | MASRURI | |
| 19 | SUWARNO | |
| 20 | WARSIYEM | |
| 21 | SANURI | |
| 22 | SOIMUN | |
| 23 | LUQFIASARI | |
| 24 | SURAHMAN | |
| 25 | WALUDI | |
| 26 | M.KHALIMI | |
| 27 | DARMINTO | |
| 28 | ISRIYAH |