 
| gm. Jasień, Precinct no. 4, Constituency no. 7 | |
| Council name | Rada Miejska w Jasieniu | 
| Constituency | Constituency no. 7 | 
| Precinct | Precinct no. 4 | 
| Electoral Commission Regional Headquarters | Szkoła Podstawowa, Golin | 
| Number of electors | 372 | 
| Number of dispensed ballot cards | 193 | 
| Number of valid ballot cards | 193 | 
| Number of votes valid | 189 | 
| Number of votes invalid | 4 | 
| Number of dispensed ballot cards for plenipotentiaries | 0 | 
| Protocol date | 22-11-2010 04:54 | 
| List no. 2 - KOMITET WYBORCZY POLSKIE STRONNICTWO LUDOWE | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Hoda Tadeusz | 83 | 43,92% | |
| List no. 12 - KOMITET WYBORCZY FORUM SAMORZĄDOWE MIAST I GMIN POWIATU ŻARSKIEGO | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Owsiany Ewa Małgorzata | 106 | 56,08% | |