| No. | Nama | Paraf |
|---|---|---|
| 1 | NUR KHAMID | |
| 2 | SURATMAN | |
| 3 | FAQIH AL IRSYAD | |
| 4 | KOLIMAH | |
| 5 | UMI SAODAH | |
| 6 | MARSITI | |
| 7 | AGUS SUPRIYONO | |
| 8 | SAMUDI | |
| 9 | SUPRATNO SLAMET | |
| 10 | SUYITNO SUKIR | |
| 11 | DARSONO | |
| 12 | SUDADI | |
| 13 | MARYADI | |
| 14 | NGARBITO | |
| 15 | HARYADI | |
| 16 | SITI ROHMI | |
| 17 | SUDADI | |
| 18 | MULYONO | |
| 19 | SUWARDI | |
| 20 | PAIRAH | |
| 21 | SUTRISNO | |
| 22 | RUKINAH | |
| 23 | SUYAMIN | |
| 24 | MUKHSININ | |
| 25 | SULISTYO | |
| 26 | WAHADI | |
| 27 | SAMSUL MA'ARIF | |
| 28 | HARUN | |
| 29 | SUHARDI | |
| 30 | SLAMET FATONI |