| No. | Nama | Paraf |
|---|---|---|
| 1 | SLAMET MISBAH | |
| 2 | MAHMUD ANWAR MUKOROBIN | |
| 3 | ARIF TABI'IN | |
| 4 | MUSTANGIN | |
| 5 | EFI TRI WARDANI | |
| 6 | SLAMET MUHYIDIN | |
| 7 | ALPIYAH | |
| 8 | ASMA'UN | |
| 9 | NGAISAH | |
| 10 | SOLIKIN | |
| 11 | NASIRUN | |
| 12 | KAYAT | |
| 13 | ZAMRORI | |
| 14 | ROKHANIYAH | |
| 15 | MUDJASI | |
| 16 | MUH SUHUDI | |
| 17 | SITI MAEMONAH | |
| 18 | SUPARNO SAIFUL ANWAR | |
| 19 | CHOERONI | |
| 20 | MUNTAALIM | |
| 21 | ABRORI | |
| 22 | ISRI | |
| 23 | PURWANTO | |
| 24 | MARKHAMI | |
| 25 | ISTILAH | |
| 26 | SAIDI EDDY | |
| 27 | MUHAMMAD SURO MANQU NEGORO | |
| 28 | MUCHAMAD SOLIKUN | |
| 29 | ARI NOFIYANTO | |
| 30 | TASYIRUDIN HIDAYAT | |
| 31 | FRIGARY GILANG AFRIZAL | |
| 32 | ALIF RAHMAN | |
| 33 | PARYUDI | |
| 34 | MAHMUDI | |
| 35 | ISTIKHORI | |
| 36 | SAEFUDIN |