| No. | Nama | Paraf |
|---|---|---|
| 1 | NGARIFIN | |
| 2 | RUBBIYATI | |
| 3 | NASIHIN | |
| 4 | ACHMAD MAKSUM | |
| 5 | PRAYITNO | |
| 6 | SAFI'IN | |
| 7 | DAHWANTO | |
| 8 | MUHAMMAD BAHRODIN | |
| 9 | SUMARLAN | |
| 10 | IMBUH | |
| 11 | NURYADI | |
| 12 | ISNOTO | |
| 13 | UNTUNG | |
| 14 | NURDI | |
| 15 | SLAMET | |
| 16 | MUSOLIN | |
| 17 | SARWADI | |
| 18 | SAPARUN | |
| 19 | SUMARSUM | |
| 20 | SAPARI | |
| 21 | MAESUR | |
| 22 | URIP | |
| 23 | KURDI | |
| 24 | DANI | |
| 25 | MUJITO | |
| 26 | ARIS | |
| 27 | YAMENO | |
| 28 | RATNO | |
| 29 | MANDHON | |
| 30 | IKHSAN | |
| 31 | MUKHOTIB |