| No. | Nama | Paraf |
|---|---|---|
| 1 | SLAMET MARKAMAH | |
| 2 | SUTIYAH | |
| 3 | SUMARNI | |
| 4 | ISTANTO | |
| 5 | TUMIYATI | |
| 6 | ROHMADI | |
| 7 | NUR MAHMUDI | |
| 8 | PITOYO | |
| 9 | SHODIKIN | |
| 10 | SUWARISMAN | |
| 11 | SUMIDAH | |
| 12 | WAHID EFENDI | |
| 13 | SUHADI | |
| 14 | KHOLIK MACHFUDIN | |
| 15 | ISWANDI | |
| 16 | YATIMAH | |
| 17 | PUJI | |
| 18 | NURGIYANTO | |
| 19 | SUKINO | |
| 20 | WAHDIRI | |
| 21 | MUJITO | |
| 22 | WALJITO | |
| 23 | ISTAMARI | |
| 24 | SISWANDI | |
| 25 | MUHRONI | |
| 26 | TARJUKI | |
| 27 | ABDI SALAM | |
| 28 | NGATIAH | |
| 29 | KABUL PURWANTO | |
| 30 | MULYONO | |
| 31 | SAIBAH | |
| 32 | ROJIKAN | |
| 33 | RATNO TUKIJO | |
| 34 | SISWOYO | |
| 35 | KOSIM | |
| 36 | TOHADI | |
| 37 | SUROSO | |
| 38 | SUBARDI | |
| 39 | SLAMET WALUYO | |
| 40 | RUWADI |