| No. | Nama | Paraf |
|---|---|---|
| 1 | SUJIMAN | |
| 2 | ARIF SUSILO | |
| 3 | BADRIYANTO | |
| 4 | NIMAS AYU RETNO GIYANSIH | |
| 5 | SUHARTO | |
| 6 | MUHLASIN | |
| 7 | WAKHID HASYIM | |
| 8 | RISTIYANI | |
| 9 | RIO MAULANA ABDA'U | |
| 10 | SURANTO | |
| 11 | NARSUM | |
| 12 | TEGUH MARYOTO | |
| 13 | RIYANTI | |
| 14 | SUGIYANTO | |
| 15 | DURI ICHSAN | |
| 16 | DARMANTO | |
| 17 | SUKIRAN | |
| 18 | SUWALDI | |
| 19 | SUPARNO | |
| 20 | SATINI | |
| 21 | SLAMET | |
| 22 | ALY MARUF | |
| 23 | SUBOWO | |
| 24 | MUJINAH | |
| 25 | ARDANI | |
| 26 | NGADINO | |
| 27 | SUYOTO | |
| 28 | SUBARDI | |
| 29 | SUTARNO | |
| 30 | SUPIYATI | |
| 31 | JUARI | |
| 32 | URIP | |
| 33 | EDY SUTRASNO | |
| 34 | PRAPTIYONO | |
| 35 | BONARI | |
| 36 | SUKARDI | |
| 37 | GUYUP WINDARTO | |
| 38 | ISDI | |
| 39 | SUNDORO | |
| 40 | RUMIYAH | |
| 41 | SULINAH |