| No. | Nama | Paraf |
|---|---|---|
| 1 | KAWIYATI | |
| 2 | MUHAMAD ZENI ILHAM | |
| 3 | SARKANTO | |
| 4 | MIYANTO | |
| 5 | WALSIH | |
| 6 | SUWALI | |
| 7 | ROBIYATI | |
| 8 | SENADI | |
| 9 | SUWARTI | |
| 10 | SURADI | |
| 11 | MUJIYAT | |
| 12 | MARSIDI | |
| 13 | SUPARMAN | |
| 14 | BLUMUT | |
| 15 | WAKIJAN | |
| 16 | SUKIDI | |
| 17 | SAMIN | |
| 18 | WELAS | |
| 19 | SAIPAN | |
| 20 | SINAH | |
| 21 | SARBUN | |
| 22 | BONI PRASETYO | |
| 23 | PARYADI | |
| 24 | WALMIN | |
| 25 | GIMIN RATMONO | |
| 26 | MUROKHIM |