| No. | Nama | Paraf |
|---|---|---|
| 1 | KUSRONI | |
| 2 | MUHDASIRI | |
| 3 | NUR ASMAK | |
| 4 | MUH KODRI | |
| 5 | ISROFIN | |
| 6 | URIP SIYAMIN | |
| 7 | CHAZINAH | |
| 8 | NASOKHA SABAR | |
| 9 | MUH DZORUN | |
| 10 | ZAENURI | |
| 11 | KHOIRODIN | |
| 12 | HARIYANTO | |
| 13 | MAH RODIN | |
| 14 | MUH ZURODIN | |
| 15 | MARDHIYAH | |
| 16 | WALMIYATUN | |
| 17 | DUL WAJIB | |
| 18 | NURHADI | |
| 19 | SITI ROFI'AH | |
| 20 | TRIMO | |
| 21 | EKO WAHYUDIYONO | |
| 22 | AGUS RIYANTO | |
| 23 | AFIF HASBI BUSTOMI | |
| 24 | ROCHMADI | |
| 25 | SUPRAN NARYANTO | |
| 26 | SAIFUL HIDAYAT | |
| 27 | SUPANGAT | |
| 28 | AFANDI | |
| 29 | DUMERI |