| No. | Nama | Paraf |
|---|---|---|
| 1 | TRIO KISWANTO | |
| 2 | MUKAYAT KHABIBI | |
| 3 | SAMAK | |
| 4 | SULAIMAN | |
| 5 | BUNYAMIN RAHMAN SYAEFUL HADI | |
| 6 | WALJUDI | |
| 7 | SURTINAH | |
| 8 | SUWARTI | |
| 9 | ROKANAH | |
| 10 | KHOLIL | |
| 11 | MARKAMAH | |
| 12 | AHMAD MUTAMAKIN | |
| 13 | JAMAT | |
| 14 | JA'FAR SODIQ | |
| 15 | MURSIDAH | |
| 16 | ABDUL ROKHIM | |
| 17 | SUDIRO | |
| 18 | TAMRI | |
| 19 | MUH AMIN | |
| 20 | SUNARIYAH | |
| 21 | PURWONO | |
| 22 | MUKIYAT | |
| 23 | NASIKIN | |
| 24 | MARWAH | |
| 25 | SARIMUN | |
| 26 | MUNAWIR | |
| 27 | ISROKHAN | |
| 28 | AROFIK |