| No. | Nama | Paraf |
|---|---|---|
| 1 | MUHAMAD NUR JOKO | |
| 2 | SRI MULASIH | |
| 3 | PODO RIYADI | |
| 4 | MURTI | |
| 5 | JASMO | |
| 6 | AHMAD TASWAN | |
| 7 | PAIT BOTOK | |
| 8 | WAHADI KATUL | |
| 9 | RESO SLAMET | |
| 10 | DANGSANG JENGGO | |
| 11 | DJUWARTO | |
| 12 | SULAMI | |
| 13 | TEGUH | |
| 14 | MOHADI | |
| 15 | DARSO | |
| 16 | ASMO PAWIRO | |
| 17 | PONIDI | |
| 18 | MUSIATI | |
| 19 | MUHAIMIN | |
| 20 | DAHLAN | |
| 21 | KEMI | |
| 22 | URIP YASWITO | |
| 23 | SUDIYONO | |
| 24 | SUSAH | |
| 25 | YAMIDI SLAMET | |
| 26 | CUNDUK | |
| 27 | MUTIYONO | |
| 28 | MIDI | |
| 29 | SUPINI | |
| 30 | SUSILO | |
| 31 | SAINI | |
| 32 | MU'I | |
| 33 | NGADI | |
| 34 | HANIF | |
| 35 | TURUT | |
| 36 | SANTO | |
| 37 | NGAHADI | |
| 38 | SLAMET |