| No. | Nama | Paraf |
|---|---|---|
| 1 | PARNITI | |
| 2 | KATIMAH | |
| 3 | PURWANTO | |
| 4 | ISWORO HANDOKO | |
| 5 | SAIFUL MUJAB | |
| 6 | DARMIUN | |
| 7 | ABDUL HARIS CHAKIM | |
| 8 | BUDIYONO | |
| 9 | MARGONO | |
| 10 | WAGIMAN | |
| 11 | TUGITO | |
| 12 | WARYONO | |
| 13 | PAINI | |
| 14 | TUKOYO | |
| 15 | ICHSAN | |
| 16 | SARINTEN | |
| 17 | UMI MAKROMAH | |
| 18 | SARYANTO | |
| 19 | SAWALI | |
| 20 | WARIYO | |
| 21 | HARMONO | |
| 22 | SUNARI | |
| 23 | BUDI | |
| 24 | AMIN | |
| 25 | SURAMI | |
| 26 | ASTANTO | |
| 27 | WIDIONO |