 
| Constituency statistic | |||||
| Constituency | Council name | Number of | |||
| electors | mandates | Committees which submitted lists for | candidates from all lists | ||
| 5 | Rada Miejska w Jasieniu | 450 | 1 | 2 | 2 | 
| Voting results for the constituency | ||||||
| Number of | ||||||
| entitled | dispensed ballot cards | votes | Attendance | valid votes | % of valid votes | |
| 450 | 189 | 189 | 42.00% | 181 | 95.77% | |
| Precinct No. | Address | Precinct type | Location accessible for the handicapped | Precinct boundaries | entitled | dispensed ballot cards | Attendance | votes | valid votes | % of valid votes | |
| 3 | Szkoła Podstawowa, Wicina | General | No | miejscowości: BIESZKÓW, GUZÓW, ROZTOKI, ŚWIBNA, WICINA, ZABŁOCIE. | 450 | 189 | 42,00% | 189 | 181 | 95,77% | |
| Totalling | 450 | 189 | 42,00% | 189 | 181 | 95,77% | |||||
| List no. 12 - KOMITET WYBORCZY FORUM SAMORZĄDOWE MIAST I GMIN POWIATU ŻARSKIEGO - Zarejestrowana | 
| Number in the list | Family name and given names | Age | Address | Number of valid votes for candidate | % of valid votes | Mandate | |
| 1 | Tracz Dorota Stanisława | 42 | Wicina | 71 | 39.23% | Nie | |
| List no. 13 - KOMITET WYBORCZY WYBORCÓW NASZA GMINA JASIEŃ - Zarejestrowana | 
| Number in the list | Family name and given names | Age | Address | Number of valid votes for candidate | % of valid votes | Mandate | |
| 1 | Chorab Jadwiga | 56 | Wicina | 110 | 60.77% | Tak | |
| *) Content of vetting statements are based on the territorial election commission announcement |