| No | Nama | Alamat | Nominal |
|---|
| 1 | KARTU/RUTIYEM | TEGUHAN | Rp 50.000,00 |
| 2 | MBAK UPIK | JERUKSARI | Rp 50.000,00 |
| 3 | WAGIR/WASIMAN | KAJAR II | Rp 30.000,00 |
| 4 | RESTU AFERINA | PAKEL REJO RT 04 | Rp 50.000,00 |
| 5 | SUPAR / MENIK | KAJAR III | Rp 30.000,00 |
| 6 | SUMIRIL | BUDEGAN 1 | Rp 30.000,00 |
| 7 | PARTINI | GEBANGAN | Rp 60.000,00 |
| 8 | DWI / SRI (MBAH DUKUN) | KAJAR I | Rp 30.000,00 |
| 9 | NGADIYONO | BPN | Rp 100.000,00 |
| 10 | MUKMIN | SAMBIREJO PONJONG | Rp 50.000,00 |
| 11 | BEKTI | SELANG | Rp 100.000,00 |
| 12 | ARI | GLIDAG | Rp 50.000,00 |
| 13 | PURWOKO / SURTINI | PERON BLEBERAN | Rp 30.000,00 |
| 14 | SOFIATUN / NIRA BUANA | KAJAR II | Rp 50.000,00 |
| 15 | SIPUR TAS / YATUN | BUDEGAN 2 | Rp 30.000,00 |