| No. | Nama | Paraf |
|---|---|---|
| 1 | MUSTOFA | |
| 2 | KEMI | |
| 3 | DWI ANGGORO SEMEDI | |
| 4 | SAYUP | |
| 5 | WALMIYATI | |
| 6 | DIDIK GUNAWAN | |
| 7 | ASMA'I | |
| 8 | BAWON | |
| 9 | WALMIN | |
| 10 | SUCIPTO | |
| 11 | KLUMPUK | |
| 12 | SARJU | |
| 13 | SUKARMIN | |
| 14 | RAMINAH | |
| 15 | DAHMI | |
| 16 | JUMADI | |
| 17 | WALSIDI | |
| 18 | WITO | |
| 19 | ISWANDI | |
| 20 | SETIYONO | |
| 21 | MARGIYAT | |
| 22 | SUROTO | |
| 23 | WALNO | |
| 24 | ARIFIN | |
| 25 | SAMIN | |
| 26 | WALUYO | |
| 27 | PARLAN |