| No. | Nama | Paraf |
|---|---|---|
| 1 | MIFTAKHUDIN | |
| 2 | TAUFIKURROHMAN | |
| 3 | TAMBAH WARDOYO | |
| 4 | MUHAMMAD FUAD HASYIM | |
| 5 | GIYANTO | |
| 6 | IRFANI | |
| 7 | GINEM | |
| 8 | JUMALI | |
| 9 | SARJONO | |
| 10 | MAUZAN | |
| 11 | MARKOSIM | |
| 12 | SLAMET MULANI | |
| 13 | SARWANI | |
| 14 | ROHMAT | |
| 15 | BUDIYARTO | |
| 16 | MUH SABAR | |
| 17 | MUHYIDIN | |
| 18 | SAODAH | |
| 19 | RUSDIYONO | |
| 20 | ISTACHORI | |
| 21 | MUKRIM | |
| 22 | ROFIYANTO | |
| 23 | PAISAH | |
| 24 | MUJIARTI | |
| 25 | SUTI | |
| 26 | SURADI | |
| 27 | ROFIIN | |
| 28 | SLAMET ELDI | |
| 29 | JUMIKO | |
| 30 | RUMADI |