 
| gm. Dębno, Precinct no. 12 | 
| Vote on 05-12-2010 | |
| Office | Wójt Gminy Dębno | 
| Precinct | Precinct no. 12 | 
| Electoral Commission Regional Headquarters | Dom Pomocy Społecznej w Porąbce Uszewskiej | 
| Number of electors | 25 | 
| Number of dispensed ballot cards | 25 | 
| Number of valid ballot cards | 25 | 
| Number of votes valid | 25 | 
| Number of votes invalid | 0 | 
| Number of dispensed ballot cards for plenipotentiaries | 0 | 
| Protocol date | 05-12-2010 11:16 | 
| No. | Family name and given names | Age | Education | Address, party membership and endorsements | Number of votes | Votes % | |
| 1 | Brach Grzegorz | 48 | wyższe | Dębno, submitted by KOMITET WYBORCZY WYBORCÓW NASZA GMINA DĘBNO, not a member of any political party | 0 | 0,00% | |
| 2 | Kozłowski Wiesław Kazimierz | 46 | wyższe | Dębno, submitted by KOMITET WYBORCZY PRAWO I SPRAWIEDLIWOŚĆ, member of Prawa i Sprawiedliwości | 25 | 100,00% | |
| Vote on 21-11-2010 | |
| Office | Wójt Gminy Dębno | 
| Precinct | Precinct no. 12 | 
| Electoral Commission Regional Headquarters | Dom Pomocy Społecznej w Porąbce Uszewskiej | 
| Number of electors | 28 | 
| Number of dispensed ballot cards | 25 | 
| Number of valid ballot cards | 25 | 
| Number of votes valid | 23 | 
| Number of votes invalid | 2 | 
| Number of dispensed ballot cards for plenipotentiaries | 0 | 
| Protocol date | 22-11-2010 00:20 | 
| No. | Family name and given names | Age | Education | Address, party membership and endorsements | Number of votes | Votes % | |
| 1 | Brach Grzegorz | 48 | wyższe | Dębno, submitted by KOMITET WYBORCZY WYBORCÓW NASZA GMINA DĘBNO, not a member of any political party | 4 | 17,39% | |
| 2 | Kozłowski Wiesław Kazimierz | 46 | wyższe | Dębno, submitted by KOMITET WYBORCZY PRAWO I SPRAWIEDLIWOŚĆ, member of Prawa i Sprawiedliwości | 0 | 0,00% | |
| 3 | Okrzesa Maria Rozalia | 65 | średnie | Porąbka Uszewska, submitted by KOMITET WYBORCZY WYBORCÓW DOBRA WSPÓLNOTA SAMORZĄDOWA, not a member of any political party | 19 | 82,61% | |