| gm. Dolsk, Precinct no. 4, Constituency no. 12 | |
| Council name | Rada Miasta i Gminy Dolsk |
| Constituency | Constituency no. 12 |
| Precinct | Precinct no. 4 |
| Electoral Commission Regional Headquarters | Przedszkole Samorządowe, ul. Ks. Marciniaka 35, Wieszczyczyn |
| Number of electors | 211 |
| Number of dispensed ballot cards | 96 |
| Number of valid ballot cards | 96 |
| Number of votes valid | 95 |
| Number of votes invalid | 1 |
| Number of dispensed ballot cards for plenipotentiaries | 0 |
| Protocol date | 22-11-2010 02:28 |
| List no. 1 - KOMITET WYBORCZY SOJUSZ LEWICY DEMOKRATYCZNEJ | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Brylewski Leon Franciszek | 12 | 12,63% | |
| List no. 2 - KOMITET WYBORCZY POLSKIE STRONNICTWO LUDOWE | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Jankowiak Kamil Krzysztof | 58 | 61,05% | |
| List no. 17 - KOMITET WYBORCZY WYBORCÓW GMINY DOLSK | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Zyffert Marek | 25 | 26,32% | |