| No. | Nama | Paraf |
|---|---|---|
| 1 | KHABIB MUSLIKHIN | |
| 2 | MISBACHUL MUNIR | |
| 3 | MUHAMAD KHUSRIN | |
| 4 | NUR HUDA | |
| 5 | MUHAMAD ASROCHIM | |
| 6 | AZKA NURUS SANI | |
| 7 | WOROBISAH | |
| 8 | ALWANDI | |
| 9 | MUSLICHUN | |
| 10 | ANWARI | |
| 11 | ROCHMADI | |
| 12 | SURIPNO | |
| 13 | KETOK SUHARTO | |
| 14 | MUHAMMAD SAID MANSUR | |
| 15 | ISTIKONAH | |
| 16 | SAE'AN | |
| 17 | DAHROJI | |
| 18 | BAHROZIN | |
| 19 | MUHAMMAD ROSIHUN | |
| 20 | SUHADI |