| No. | Nama | Paraf |
|---|---|---|
| 1 | PREMATUR JOKO SUNGKOWO | |
| 2 | ROPIYANI | |
| 3 | JUWARMINTO | |
| 4 | ROHYANI | |
| 5 | SUKIRMAN | |
| 6 | MIRAH | |
| 7 | SARIPAN | |
| 8 | NGARIMAN | |
| 9 | SUWARJO | |
| 10 | REPIN | |
| 11 | MULIDI | |
| 12 | SARJAN | |
| 13 | NGAMIN | |
| 14 | SULISNO | |
| 15 | NGATIPAR | |
| 16 | MUJIRO | |
| 17 | KAMIJEM | |
| 18 | M.MISBAHUDIN | |
| 19 | JAMINGAN | |
| 20 | MISRAN | |
| 21 | TUKIYAM | |
| 22 | TUKIJAN | |
| 23 | JUWITO | |
| 24 | ARIS BUDIANTO | |
| 25 | ANAF RISMIYATI | |
| 26 | MUKHAROM | |
| 27 | WARTI | |
| 28 | MUHIMAD | |
| 29 | SUKRAT | |
| 30 | SIYAMI |