| No. | Nama | Paraf |
|---|---|---|
| 1 | IMAM EDY SURYANTO | |
| 2 | MARSIDI | |
| 3 | FREDIYANTO | |
| 4 | SUMIDI | |
| 5 | TOFAENI | |
| 6 | PUJIANTO | |
| 7 | TEGUH | |
| 8 | SUMAR | |
| 9 | ABU WISMONO | |
| 10 | PUSWANTO | |
| 11 | ISWANDI JAIS | |
| 12 | PARSINI | |
| 13 | ASIH | |
| 14 | MURSIDAH | |
| 15 | MUNARI | |
| 16 | MUDIYONO | |
| 17 | SUNARTO SANIJU | |
| 18 | UMBUL DWI SANTOSO | |
| 19 | SUROSO | |
| 20 | WARMIDI | |
| 21 | ROBANI | |
| 22 | SISWORO SUDIRAN | |
| 23 | PARMUDI | |
| 24 | AKHMADI | |
| 25 | SARPENO | |
| 26 | MISTONI | |
| 27 | JUWEDI | |
| 28 | SUMERI | |
| 29 | MUBASIR |