| No. | Nama | Paraf |
|---|---|---|
| 1 | SAFII | |
| 2 | SETIYO RIKO | |
| 3 | NGADINAH | |
| 4 | ROMADHON | |
| 5 | MUTAQO | |
| 6 | MUKIDI | |
| 7 | AGUS | |
| 8 | KURDI | |
| 9 | MULYADI | |
| 10 | SUPRIYANTO | |
| 11 | MUH SAMBANG | |
| 12 | SARYADI | |
| 13 | PAIJO | |
| 14 | SUDARMAN | |
| 15 | MUHTAR | |
| 16 | SUYI | |
| 17 | PARWITO | |
| 18 | SAKIMAN | |
| 19 | MURSIDAH | |
| 20 | TURAMIN | |
| 21 | SAIFUL HUDHA | |
| 22 | TUTI AMANAH | |
| 23 | KAMIJAN | |
| 24 | TUMIYATUN | |
| 25 | NUR NASIKHUN | |
| 26 | ASKUR | |
| 27 | HARDIYANTO |