| No. | Nama | Paraf |
|---|---|---|
| 1 | AVIP ROHMAN | |
| 2 | MUSOFA | |
| 3 | WATINI | |
| 4 | SUIRMAN | |
| 5 | TIKWO | |
| 6 | RAHAYU KRISBIANTORO | |
| 7 | SIYAMAH | |
| 8 | SUYANTO | |
| 9 | AMINI | |
| 10 | HARUN | |
| 11 | SUMARTO | |
| 12 | SLAMET | |
| 13 | MARWAN AL ZAENUDIN | |
| 14 | PARIJAN | |
| 15 | SARMANTO | |
| 16 | KOMEDI | |
| 17 | AMIN SUCIPTO | |
| 18 | EKO SUSANTO | |
| 19 | UMAR | |
| 20 | SLAMET WAKIDI | |
| 21 | ISTOFA | |
| 22 | BOTOK |