| gm. Wieruszów, Precinct no. 12, Constituency no. 5 | |
| Council name | Rada Miejska w Wieruszowie |
| Constituency | Constituency no. 5 |
| Precinct | Precinct no. 12 |
| Electoral Commission Regional Headquarters | Powiatowe Centrum Medyczne w Wieruszowie Sp. z o.o. NZOZ Szpital Powiatowy w Wieruszowie ul. Warszawska 104 |
| Number of electors | 6 |
| Number of dispensed ballot cards | 1 |
| Number of valid ballot cards | 1 |
| Number of votes valid | 1 |
| Number of votes invalid | 0 |
| Number of dispensed ballot cards for plenipotentiaries | 0 |
| Protocol date | 21-11-2010 22:44 |
| List no. 4 - KOMITET WYBORCZY PLATFORMA OBYWATELSKA RP | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Kwiatkowski Krzysztof Jan | 0 | 0,00% | |
| List no. 5 - KOMITET WYBORCZY PRAWO I SPRAWIEDLIWOŚĆ | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Rybak Adam | 1 | 100,00% | |
| 2 | Zakręta Radosław Paweł | 0 | 0,00% | |
| List no. 15 - KOMITET WYBORCZY WYBORCÓW "ZGODA" | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Lenart Stanisław Antoni | 0 | 0,00% | |
| 2 | Winkowska Aneta Maria | 0 | 0,00% | |
| List no. 18 - KOMITET WYBORCZY WYBORCÓW JÓZEFA WRÓBLA | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Sułot-Drobnik Katarzyna | 0 | 0,00% | |
| 2 | Kudaś Wojciech Andrzej | 0 | 0,00% | |
| List no. 19 - KOMITET WYBORCZY NASZ DOM POLSKA - SAMOOBRONA ANDRZEJA LEPPERA | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Ostrycharz Paweł Franciszek | 0 | 0,00% | |
| List no. 20 - KOMITET WYBORCZY WYBORCÓW OBYWATELSKA GMINA WIERUSZÓW | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Lis Andrzej Roman | 0 | 0,00% | |
| 2 | Karkoszka Stanisław | 0 | 0,00% | |