| No. | Nama | Paraf |
|---|---|---|
| 1 | SARIYATI | |
| 2 | MARIYAM | |
| 3 | ASTURI | |
| 4 | HADI SUTARNO | |
| 5 | PARJONO | |
| 6 | ZAENUR | |
| 7 | SAPARDI ARUM | |
| 8 | TRISNO MIHARJO | |
| 9 | MURSIYEM | |
| 10 | KRISNANTO | |
| 11 | WALIMAH | |
| 12 | ROMIDAH | |
| 13 | BUDI HARYONO | |
| 14 | WARDOYO | |
| 15 | SURAJI | |
| 16 | SUMARIYONO | |
| 17 | SUDARMONO | |
| 18 | ROHMAN | |
| 19 | ISROIL | |
| 20 | TEGUH SUSILO | |
| 21 | ABU HASAN | |
| 22 | ARIYANTO | |
| 23 | HERMANTO | |
| 24 | SUYANTO | |
| 25 | MULYONO | |
| 26 | EDIK JATMIKO | |
| 27 | YASIMAN | |
| 28 | IKHSANUDIN | |
| 29 | TOTOT VRADIYANTO | |
| 30 | AGUS SUSANTO |