| No. | Nama | Paraf |
|---|---|---|
| 1 | RIWAYAT | |
| 2 | HARI FITRODIN | |
| 3 | HASYIM ASNGARI | |
| 4 | YOKO SETIAWAN | |
| 5 | ACHMAT ROFI'I | |
| 6 | SUSANTO | |
| 7 | ZAINUDIN SUSILO | |
| 8 | MUARIF TRIAWAN | |
| 9 | JAJANG | |
| 10 | MUHSAN | |
| 11 | EKO MADIYANTO | |
| 12 | MULYADI | |
| 13 | RUDJIJATUN | |
| 14 | MUH YASIN | |
| 15 | TRIYONO | |
| 16 | SUTIYONO | |
| 17 | SUPIYAH | |
| 18 | WARIYAM | |
| 19 | UMAR CHOIRI | |
| 20 | DAHROJI | |
| 21 | ALI SURAT | |
| 22 | JANURI | |
| 23 | MUHTUBI | |
| 24 | SURJANI | |
| 25 | IKHWANUDIN | |
| 26 | ROMIYATUN | |
| 27 | DULSUKRI | |
| 28 | JUWAHIR | |
| 29 | SARMI | |
| 30 | MULYANTO | |
| 31 | ROSIDAH | |
| 32 | MUBARI | |
| 33 | KUKUH MUHIDIN | |
| 34 | ALI MAS'UT | |
| 35 | SUGIYO | |
| 36 | NUR HAMID | |
| 37 | SUTIONO | |
| 38 | SULEMAN | |
| 39 | SUPINAH | |
| 40 | KUSNA SUJARWADI | |
| 41 | SUPARMI | |
| 42 | SARJONO | |
| 43 | NANAK SURYANA | |
| 44 | SUPARDI | |
| 45 | NUR FAIZIN |