| No. | Nama | Paraf |
|---|---|---|
| 1 | KHABIBUN | |
| 2 | MUHAMAD MUHTADIN | |
| 3 | TARWIYADI | |
| 4 | SUSILO | |
| 5 | NURKHOLIK | |
| 6 | MUNDIUN | |
| 7 | KHAMSAH | |
| 8 | ZAENATUN | |
| 9 | KUWAT | |
| 10 | SENI | |
| 11 | SAMIUN | |
| 12 | DANAR RIKSA | |
| 13 | SARINAH | |
| 14 | SUMAERI | |
| 15 | SUTARYONO | |
| 16 | SUSILO | |
| 17 | MARIYONO | |
| 18 | PUJI SETYOWATI | |
| 19 | KHOTIMUN | |
| 20 | TAMYIS | |
| 21 | NUR YAHMIN | |
| 22 | BANDIYAH | |
| 23 | SOFI'I | |
| 24 | MUHYIDIN | |
| 25 | NUR ZAENUDIN | |
| 26 | SHOBRI | |
| 27 | SAHMAN | |
| 28 | KHAERI | |
| 29 | TASLIM | |
| 30 | ASWA'IN | |
| 31 | MIHAN | |
| 32 | SITI ROHAYAH | |
| 33 | SADARUDIN | |
| 34 | TUWADI | |
| 35 | SLAMET RIYADI | |
| 36 | WALDI | |
| 37 | TABAH PRIYANTO | |
| 38 | MUKHAMAD HAMIM | |
| 39 | PARINGONO TEGUH | |
| 40 | AKHMAD SARITO | |
| 41 | BUYAMIN |