| No. | Nama | Paraf |
|---|---|---|
| 1 | NANANG | |
| 2 | MUHAMMAD RIFA'I | |
| 3 | BOBI SUSILO | |
| 4 | ROYIN | |
| 5 | WAHYUDIN | |
| 6 | AMIN MUSTOFA | |
| 7 | ADI BURHANUDIN | |
| 8 | ROCHMAT SODIKIN | |
| 9 | AMIN WAHYUDI | |
| 10 | RUM BINTARIYATI | |
| 11 | SUTEJO | |
| 12 | DARSIYAM | |
| 13 | ACHADUN | |
| 14 | MUJIONO | |
| 15 | REMBEN | |
| 16 | SARMADI | |
| 17 | MULYONO | |
| 18 | ALI ROCHMAT | |
| 19 | SUKRO | |
| 20 | MAWARDI | |
| 21 | WAHADI | |
| 22 | SAJURI | |
| 23 | SUROCHMAT | |
| 24 | SIYAMTO | |
| 25 | SUPRIYATI | |
| 26 | WALUYO | |
| 27 | ABDULAH AHMADUN | |
| 28 | JUWAEDI | |
| 29 | SUWARDI | |
| 30 | TRIJONO | |
| 31 | MUHAMAD TUBANIYAH | |
| 32 | MUSLIMAT | |
| 33 | SLAMET ARIYADI | |
| 34 | SUMPENO | |
| 35 | SISLAENI | |
| 36 | MUNAJAT | |
| 37 | ABU SUKUR | |
| 38 | PIRMAN | |
| 39 | ISTRI SINTOK | |
| 40 | TUBANIYAH |