| No. | Nama | Paraf |
|---|---|---|
| 1 | GUNAWAN | |
| 2 | JAYARI | |
| 3 | YULIYANTI | |
| 4 | HADI MUTAAT | |
| 5 | UKIK SIYAMTO | |
| 6 | SUYANTO | |
| 7 | SURAMIN | |
| 8 | SOENGKONO | |
| 9 | MULYONO | |
| 10 | TURYONO | |
| 11 | RUWANTO | |
| 12 | SUKIYAH | |
| 13 | DUMERI | |
| 14 | BLUMUT | |
| 15 | SUYADI | |
| 16 | SATINAH | |
| 17 | SUTIYEM | |
| 18 | SLAMET | |
| 19 | PONIYEM | |
| 20 | KABUL | |
| 21 | SUDIYONO | |
| 22 | SURAMTO | |
| 23 | EKO SUSILO | |
| 24 | MARDI SIHONO | |
| 25 | SOLIKIN | |
| 26 | WAGINI | |
| 27 | RAHMAT RO'IS |